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This is VAERS ID 264742

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 264742 (history)  
Form: Version .0  
Age: 22.0  
Gender: Female  
Location: Maryland  
Vaccinated:2006-09-12
Onset:2006-09-12
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:31
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0702F / - UN / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Hypoaesthesia
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Information has been received from a physician concerning a 22 year old female pt who on 9/12/06 was vaccinated IM into the upper left buttock with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653650/0702F. there was no concomitant medication. Appr"ox one hour post vaccination the pt experienced numbness and tingling on the right side of her face. medial attention was sought. No other symptoms were noted. As of the report date, the pt was recovering. Additional information has been requested.


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=264742


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