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This is VAERS ID 263216

Case Details

VAERS ID: 263216 (history)  
Age: 15.0  
Gender: Female  
Location: California  
Vaccinated:2006-08-17
Onset:2006-08-17
   Days after vaccination:0
Submitted: 2006-09-14
   Days after onset:28
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 AR / IM

Administered by: Private       Purchased by: Private
Symptoms: Nausea
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0608USA04465

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 17-AUG-2006 was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). There was no concomitant medication. On 17-aug-2006 the patient experienced nausea. Unspecified medical attention was sought. At the time of this report, the patient''s nausea persisted. Additional information has been requested. This is in follow-up to report(s) previously submitted on 9/14/2006. Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 17-AUG-2006 at 3:00 PM was vaccinated intramuscularly in the deltoid with the first dose of GARDASIL (lot # 653650/0702F). There were no illnesses at time of vaccination. There was no concomitant medication. On 17-AUG-2006 at 6:00 PM the patient experienced severe nausea. The patient subsequently recovered from the nausea on 21-AUG-2006. No further information is expected.


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