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This is VAERS ID 269162

Case Details

VAERS ID: 269162 (history)  
Age:   
Gender: Female  
Location: Wyoming  
Vaccinated:2006-10-10
Onset:2006-10-10
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:178
Entered: 2006-12-18
   Days after submission:108
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza like illness, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0610USA12076

Write-up: Initial and follow up information has been received from a Registered Nurse concerning a white female patient who on the afternoon of 10 Oct 206 was vaccinated IM with her first dose of Gardasil (yeast), lot #653650/0720F, and experienced flu-like symptoms and vomiting. No medical attention was sought. Within a day or two, the patient recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Initial and follow up information has been received from a Registered Nurse concerning a white female patient who on the afternoon of 10-OCT-2006 was vaccinated IM with her first dose of GARDASIL, lot #653650/0702F, and experienced flu-like symptoms and vomiting. No medical attention was sought. Within a day or two, the patient recovered. Follow up information indicated that the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


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