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This is VAERS ID 265676

Case Details

VAERS ID: 265676 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: North Carolina  
Vaccinated:2006-10-17
Onset:2006-10-22
   Days after vaccination:5
Submitted: 2006-10-26
   Days after onset:4
Entered: 2006-10-31
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Anxiety, Cough, Hypersensitivity, Hypoaesthesia, Paraesthesia, Psychomotor hyperactivity, Pyrexia
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Akathisia (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Hostility/aggression (broad), Depression (excl suicide and self injury) (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: Thyroid, Potassium levels done. Given flu vaccine 10/27/06
CDC Split Type:

Write-up: Fever, cough, numb, and tingling all over, acted hyperactive loopy, taking OTC cold remedies, MD suggested Claritin and nasal spray for allergies, may need anti anxiety and anti depressant for ADHD, anxiety.


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