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This is VAERS ID 267484

Case Details

VAERS ID: 267484 (history)  
Form: Version 1.0  
Age:   
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. - / UNK 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
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:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA00924

Write-up: Information has been received from a registered nurse concerning a female (age not reported) who on 10/30/06 was vaccainted with HPV vaccine. Subsequently, the pt experienced redness in her face and had vomited. The pt sought unspecified medical attention. At the time of this report, the pt was recovering from the event. Additional information has been requested.


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