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This is VAERS ID 267410

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

Case Details

VAERS ID: 267410 (history)  
Form: Version .0  
Age: 21.0  
Gender: Female  
Location: Florida  
Vaccinated:2006-07-19
Onset:2006-07-19
   Days after vaccination:0
Submitted: 2006-11-14
   Days after onset:118
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0697F / 0 UN / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Fatigue, Malaise, Mood swings
SMQs:, Dementia (broad), Depression (excl suicide and self injury) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Papilloma viral infection, Penicillin allergy, Asthma.
Allergies:
Diagnostic Lab Data: Serum Epstein Barr neg
CDC Split Type:

Write-up: Information has been received from a nurse concerning a 21 year old female with asthma, unspecified drug reaction to Penicillin and Amoxicillin and might have been exposed to papilloma viral infection. On 7/19/06, the pt was vaccinated IM with the first d"ose of HPV vaccine (lot 653650/0697F). Concomitant therapy included unspecified hormonal contraceptives. Subsequently, the pt experienced fatigue, was sick and had mood swings for two months. It was reported that the pt felt rotten after receiving HPV vac


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