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This is VAERS ID 269226

Case Details

VAERS ID: 269226 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-11-08
Onset:2006-11-15
   Days after vaccination:7
Submitted: 2006-12-14
   Days after onset:29
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Acne
SMQs:

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: WAES0611USA07365

Write-up: Information has been received from a nurse practitioner concerning an 18 year old female who on 08 Nov 2006 was vaccinated with a 0.5ml dose of HPV vaccine. Within one week the patient developed facial acne. Unspecified medical attention was sought. At the time of this report, the patient had not recovered. No product quality complaint was involved. Additional information has been requested.


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