|
VAERS ID: |
268287 (history) |
Form: |
Version 1.0 |
Age: |
21.0 |
Sex: |
Female |
Location: |
Massachusetts |
Vaccinated: | 2006-09-25 |
Onset: | 0000-00-00 |
Submitted: |
2006-11-30 |
Entered: |
2006-12-05 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0688F / UNK |
UN / IM |
Administered by: Other Purchased by: Other Symptoms: Epistaxis,
Headache,
Platelet count decreased,
Thrombocytopenia SMQs:, Haematopoietic thrombocytopenia (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Systemic lupus erythematosus (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 0 days
Extended hospital stay? No
Previous Vaccinations: Other Medications: NONE Current Illness: Preexisting Conditions: Idiopathic thrombocytopenic purpura. Allergies: Diagnostic Lab Data: Head computed axial 9/6 unspecified, spinal tap 9/06 results unspecified. Platelet count 9/06 43000 CDC Split Type: WAES0611USA06464
Write-up: Information has been received from a physician concerning a 21 year old female with no history of drug reactions/allergies, and a history of idiopathic thrombocytopenic purpura who on 9/25/06 was vaccinated IM with HPV vaccine (Lot 653735/0688F). There was no concomitant medications. In Sept 2006, a few days after vaccination the pt experienced a headache, nose bleed and developed thrombocytopenia. The pts platelet count on an unspecified date was 43,000. The pt was hospitalized and received platelet transfusion. A CT of the head and lumbar puncture were performed, however the results were unspecified. The pt subsequently recovered on an unspecified date. The reporting physician felt that one or more of the events was an other important medical event (OMIC) and life threatening. Additional Information has been requested. |
|
VAERS ID: |
268288 (history) |
Form: |
Version 1.0 |
Age: |
17.0 |
Sex: |
Female |
Location: |
Colorado |
Vaccinated: | 2006-11-21 |
Onset: | 2006-11-21 |
Days after vaccination: | 0 |
Submitted: |
2006-11-30 |
Days after onset: | 9 |
Entered: |
2006-12-05 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0868F / 1 |
UN / IM |
Administered by: Other Purchased by: Other Symptoms: Convulsion SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: NONE Current Illness: Preexisting Conditions: Allergies: Diagnostic Lab Data: CDC Split Type: WAES0611USA07061
Write-up: Information has been received from a physician concerning a 17 year old female who on 11/21/06 was vaccinated with an initial dose of HPV Vaccine IM in the deltoid. On 11/21/06, after the initial dose, the pt experienced a seizure. The pt was alert shortly after the event and was sent to the emergency department as a precaution. It is unk if the pt was admitted to the hospital. The pt is recovering from seizure. The pt will not continue with subsequent doses of vaccine. Upon internal review, seizure was considered an other important medical event (OMIC). Additional information has been requested. |
|
VAERS ID: |
268415 (history) |
Form: |
Version 1.0 |
Age: |
27.0 |
Sex: |
Female |
Location: |
Minnesota |
Vaccinated: | 2006-10-03 |
Onset: | 2006-10-03 |
Days after vaccination: | 0 |
Submitted: |
2006-10-27 |
Days after onset: | 24 |
Entered: |
2006-12-06 |
Days after submission: | 40 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0689F / UNK |
- / - |
Administered by: Unknown Purchased by: Unknown Symptoms: Pain,
Paraesthesia SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: None Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Injection left deltoid with HPV vaccine, immediate pain, transient finger tingling. Pain persists with movement and pressure only, 10/27/06. |
|
VAERS ID: |
268459 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 2006-12-05 |
Onset: | 2006-12-05 |
Days after vaccination: | 0 |
Submitted: |
2006-12-06 |
Days after onset: | 1 |
Entered: |
2006-12-06 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Cold sweat,
Difficulty in walking,
Disorientation,
Dizziness,
Dyskinesia,
Gait disturbance,
Headache,
Hyperventilation,
Pallor,
Paraesthesia,
Tinnitus,
Tremor SMQs:, Anaphylactic reaction (broad), Asthma/bronchospasm (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (narrow), Dementia (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Eosinophilic pneumonia (broad), Hearing impairment (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad), Dehydration (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: none Current Illness: none Preexisting Conditions: Shellfish Allergies: Diagnostic Lab Data: none CDC Split Type:
Write-up: With in five minutes of administration complaint of headache, then felt faint. I had my daughter sit down in the waiting room with her head down before we walked out. Not thinking this had anything to do with the vaccine. We walked out the door and she began have difficlty walking, weaving, I asked her if she was okay and she could only respond yes. I took her arm and tried to turn her back to the Doctor''s office and she collapsed on the ground. Though, she remainded conscious her eyes were glazed and was disoriented. It happened that another lady was leaving the office and I asked for her assitance to walk her back inside. The nurse immediately had us put her on an exam table. I do not think she was able to hear a blood pressure. At this point, my daughter was extremely pale, clammy, shallow rapid breathing, weak pulse, able to anwser questions. She stated her ears were ringing and that she had tingling in her feet. The doctor naturally examined her as well. They treated her with oral fluids, rest and some sugar cookies(the only thing they had). I am not sure the exact time the vaccine was administered. I believe it was around 5pm. When we left the doctors office, it was 5:45, my daughter felt weak and was shaky (visible). On the drive home she experienced visible muscle contractions in her arms and legs. Legs and arms were involuntarily jerking. This lasted approximately 10 minutes. By 6:00pm she felt "normal". |
|
VAERS ID: |
268483 (history) |
Form: |
Version 1.0 |
Age: |
22.0 |
Sex: |
Female |
Location: |
Maryland |
Vaccinated: | 2006-09-05 |
Onset: | 2006-09-05 |
Days after vaccination: | 0 |
Submitted: |
2006-12-04 |
Days after onset: | 90 |
Entered: |
2006-12-07 |
Days after submission: | 3 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0702F / 2 |
UN / - |
Administered by: Other Purchased by: Other Symptoms: Abortion,
Laboratory test abnormal,
Unintended pregnancy SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: Papanicolaou smear abnormal. Allergies: Diagnostic Lab Data: Colposcopy 9/06, ultrasound 9/06/06 no fetal pole, ultrasound 9/20/06 16P 5 wk 3 days. CDC Split Type: WAES0610USA00280
Write-up: Information has been received from a healthcare worker for the pregnancy registry for HPV vaccine concerning a 22 year old female pt whit a history of abnormal pap who on 6/29/06 was vaccainted with her first dose of HPV vaccine , lot 653650/0697F. On 9/5/06 the pt was vaccinated with her second dose of HPV vaccine, lot 653650/0702F. The reporter indicated that the pt received the 2nd vaccination but did not realize she was about 6 weeks pregnant at the time. Medical attention was sought. An ultrasound and colposcopy was performed. The reporter indicated that there was no fetal pole at the time of the ultrasound and that it would be repeated. There was no adverse experience reported. Follow up information has been received from a physician concerning the female pt, whose last menstrual period was approximately 9/9/06. The estimated date of conception was 8/30/06. An ultrasound performed 9/20/06 showed 16P 5 wk 3 days. This is the pts first pregnancy. The estimated delivery date is 5/21/07. Follow up information has been received. On 11/8/06 the pt underwent an elective termination of her pregnancy at 12 week from LMP. Upon internal review, elective termination of pregnancy was considered to be an other important medical event (OMIC). Additional information is not expected. |
|
VAERS ID: |
268513 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Female |
Location: |
Minnesota |
Vaccinated: | 2006-12-04 |
Onset: | 2006-12-05 |
Days after vaccination: | 1 |
Submitted: |
2006-12-06 |
Days after onset: | 1 |
Entered: |
2006-12-07 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0637F / 1 |
RA / IM |
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR |
U2094AA / 1 |
LA / IM |
Administered by: Private Purchased by: Unknown Symptoms: Injection site reaction,
Pruritus SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: NONE Preexisting Conditions: Allergic to Septra Allergies: Diagnostic Lab Data: NONE CDC Split Type:
Write-up: Local pruritic reaction at injection site without erythema, edema left deltoid. |
|
VAERS ID: |
268544 (history) |
Form: |
Version 1.0 |
Age: |
16.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 2006-12-05 |
Onset: | 2006-12-06 |
Days after vaccination: | 1 |
Submitted: |
2006-12-07 |
Days after onset: | 1 |
Entered: |
2006-12-08 |
Days after submission: | 1 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0637F / UNK |
- / IM |
TDAP: TDAP (ADACEL) / SANOFI PASTEUR |
C2457AA / UNK |
- / IM |
Administered by: Private Purchased by: Unknown Symptoms: Dizziness,
Headache,
Insomnia,
Syncope SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: NONE Preexisting Conditions: Allergies: Diagnostic Lab Data: CT Scan CDC Split Type:
Write-up: Several hours after vaccines given pt complained of HA and dizziness, insomnia. Next am s/s worse fainted. taken by paramedics to Hospital ER on 12/6/06. |
|
VAERS ID: |
268587 (history) |
Form: |
Version 1.0 |
Age: |
27.0 |
Sex: |
Female |
Location: |
California |
Vaccinated: | 2006-09-27 |
Onset: | 2006-10-13 |
Days after vaccination: | 16 |
Submitted: |
2006-12-09 |
Days after onset: | 57 |
Entered: |
2006-12-09 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Contusion,
Pruritus,
Rash SMQs:, Anaphylactic reaction (broad), Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Current Illness: Preexisting Conditions: Allergic to penicillin, which I told the doctor. Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Approx. two weeks after I received the HPV vaccine I started breaking out in red bumps mostly all over my lower body and now I have this weird purple spots on my right thigh. It has itched me so bad that I have bruises all over my legs. |
|
VAERS ID: |
268628 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
New York |
Vaccinated: | 2006-10-01 |
Onset: | 2006-10-01 |
Days after vaccination: | 0 |
Submitted: |
2006-12-06 |
Days after onset: | 66 |
Entered: |
2006-12-11 |
Days after submission: | 5 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
UN / UN |
Administered by: Other Purchased by: Other Symptoms: Condition aggravated,
Convulsion SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: Convulsions Allergies: Diagnostic Lab Data: CDC Split Type: WAES0611USA07474
Write-up: Information has been received from a physician concerning a female pt with seizures who in approx Oct 2006, about two months ago, was vaccinated IM with a first 0.5ml dose of HPV vaccine. Right after receiving the vaccination, the pt started to have seizures every day for about two weeks after receiving the vaccine. It was noted that the pt already has seizures but had them once or twice a week not everyday. Subsequently, the pt recovered. Upon internal review, seizures was considered to be an other important medical event (OMIC). Additional information has been requested. |
|
VAERS ID: |
268992 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Female |
Location: |
Michigan |
Vaccinated: | 2006-11-22 |
Onset: | 2006-11-30 |
Days after vaccination: | 8 |
Submitted: |
2006-12-15 |
Days after onset: | 15 |
Entered: |
2006-12-15 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0954F / 1 |
LA / IM |
Administered by: Unknown Purchased by: Unknown Symptoms: Rash erythematous SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: Zithromax, Orthotrycyclen Current Illness: Dysmonorrhea, Sinusitis Preexisting Conditions: Allergy to Cephalosporins, Penicillin and Sulfa Allergies: Diagnostic Lab Data: None CDC Split Type:
Write-up: One week after injection, pt. has had a patchy, dry, erythemous rash 1 cm. in circumference show up intermittently on trunk and extremities. Rash remits and recurs. No history of rash. |
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