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This is VAERS ID 269227

Case Details

VAERS ID: 269227 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2006-12-14
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: Malaise
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: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0611USA07417

Write-up: Information has been received from the mother of a 21 year old female with penicillin allergy who in 2006 was vaccinated with HPV vaccine. There was no concomitant medication. The patient''s mother stated that following vaccination, her daughter was sick. Unspecified medical attention was sought. At the time of this report, the patient was recovering. No further information is expected.


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