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This is VAERS ID 269203

Case Details

VAERS ID: 269203 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Arizona  
Vaccinated:2006-11-13
Onset:2006-11-13
   Days after vaccination:0
Submitted: 2006-12-14
   Days after onset:31
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Decreased appetite, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0611USA04596

Write-up: Information has been received from a nurse practitioner concerning a 20 year old female who on 13-NOV-2006 was vaccinated intramuscularly with the first dose of Gardasil (yeast) (Lot # not provided). On 13-NOV-2006 the patient experienced nausea, vomiting and decreased appetite. Unspecified medical attention was sought. At the time of this report it was unknown if the patient had recovered from these events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Follow-up information from the nurse practitioner indicated that the patient recovered. Additional information is not expected.


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