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This is VAERS ID 269217

Case Details

VAERS ID: 269217 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Oregon  
   Days after vaccination:0
Submitted: 2006-12-14
   Days after onset:78
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Private
Symptoms: Injection site pain, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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: Pain ankle
Preexisting Conditions: Hypersensitivity; Attention deficit/hyperactivity disorder
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA06105

Write-up: Information has been received from a physician''s nurse concerning a 15 year old female who on 27 Sep 2006 was vaccinated intramuscularly with HPV vaccine (lot # 653937/0637F). On 28 Sept 2006 the patient experienced nausea, fever and soreness at the injection site. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown.

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