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This is VAERS ID 269174

Case Details

VAERS ID: 269174 (history)  
Age: 19.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-11-02
Onset:2006-11-02
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:154
Entered: 2006-12-18
   Days after submission:108
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0696F / 0 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Headache, Nausea, Pain, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0611USA02205

Write-up: Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-2006, the next morning the patient had recovered from all of the events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-NOV-2006 was vaccinated with the first dose of GARDASIL (Lot # 653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-NOV-2006 the patient developed nausea, dizziness, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-NOV-2006. On 03-NOV-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


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