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This is VAERS ID 267480

Case Details

VAERS ID: 267480 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Oregon  
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted: 2006-11-14
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Human papilloma virus test positive, Smear cervix
SMQs:

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: UNK
Current Illness: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC Split Type: WAES0611USA00721

Write-up: Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


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