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This is VAERS ID 267476

Case Details

VAERS ID: 267476 (history)  
Age: 13.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-10-30
Onset:2006-10-30
   Days after vaccination:0
Submitted: 2006-11-14
   Days after onset:15
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Erythema, Vomiting
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA00600

Write-up: Information has been received from a registered nurse concerning a 13 year old female who on 30-OCT-2006 was vaccinated with GARDASIL. Subsequently, the patient experienced redness in her face and had vomited. The patient sought unspecified medical attention. At the time of this report, the patient was recovering from the event. Additional information has been requested.


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