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This is VAERS ID 264743

Case Details

VAERS ID: 264743 (history)  
Age: 21.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-09-11
Onset:2006-09-12
   Days after vaccination:1
Submitted: 2006-10-31
   Days after onset:49
Entered: 2006-10-17
   Days after submission:14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Feeling abnormal, Headache, Malaise, Mydriasis
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Vestibular disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Wellbutrin, Klonopin, Lexapro, Nicomide, Minocycline.
Current Illness:
Preexisting Conditions: Syncope, Anxiety.
Diagnostic Lab Data: UNK
CDC Split Type: WAES0609USA02502

Write-up: Information has been received from a registered nurse concerning a 21 year old female with syncope, anxiety and no known allergies reported. On 9/11/06, the pt was vaccinated IM with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0702F). Concomitant therapy included Lexapro, Wellbutrin, Klonopin, Nicomide, and Zithromax. On 9/12/06 when the pt woke up, she complained of her pupils being dilated, a headache, light headed and reported that she feels like something in not quite right. It was reported that it was unknown if the pt had eaten that day. The pt sought unspecified medical attention. At the time of this report, the pt had not recovered from the events. Additional information has been requested.


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