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This is VAERS ID 269235

Case Details

VAERS ID: 269235 (history)  
Form: Version 1.0  
Gender: Female  
Location: California  
   Days after vaccination:0
Submitted: 2006-12-14
   Days after onset:16
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, High-pitched crying, Malaise, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (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:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0612USA00007

Write-up: Information has been received from a nurse concerning a female co worker (age not reported) who on 28 Nov 2006 was vaccinated intramuscularly in the deltoid with the first single dose vial of HPV vaccine. The nurse reported that the patient had an experience during and immediately after being vaccinated. The nurse reported that when the patient was given the shot, she started screaming almost immediately and reported that she did not feel well. The nurse also reported that the patient felt like she was going to pass out and was feeling nauseated. The patient was sent home from work and was now out a second day from work. The patient sought unspecified medical attention. At the time of this report, the outcome of the events were unknown as the patient had not returned to work. Additional information has been requested.

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