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This is VAERS ID 263862

Case Details

VAERS ID: 263862 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-09-28
Onset:2006-09-29
   Days after vaccination:1
Submitted: 2006-10-02
   Days after onset:3
Entered: 2006-10-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Anorexia, Back pain, Fatigue, Headache, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Fatigue, Headache, Backaches, Temp 103, no appetite, x 3 days then was ok no treatment.


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