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This is VAERS ID 264748

Case Details

VAERS ID: 264748 (history)  
Age: 20.0  
Gender: Female  
Location: Indiana  
Vaccinated:2006-09-12
Onset:2006-09-13
   Days after vaccination:1
Submitted: 2006-10-13
   Days after onset:30
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0641F / 0 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MICROGESTIN FE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Body temp 09/13/06 103.6 degr
CDC Split Type: WAES0609USA03694

Write-up: Initial and follow up information has been received from a physician concerning a 20 year old female patient with sulfonamide allergy who on 12-SEP-2006 at 13:45 p.m. was vaccinated IM in the left deltoid with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast), lot #653650/0641. Concomitant therapy included ethinyl estradiol (+) ferrous fumarate (+) norethindrone acetate (MICROGESTIN FE). On the early morning of 13-SEP-2006 the patient developed a fever to 103.6 degrees F, and generalized body aches. Medical attention was sought. On 18-SEP-2006, the patient recovered. Additional information is not expected.


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