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This is VAERS ID 269264

Case Details

VAERS ID: 269264 (history)  
Age:   
Gender: Female  
Location: Wyoming  
Vaccinated:2006-08-10
Onset:2006-08-10
   Days after vaccination:0
Submitted: 2006-12-14
   Days after onset:126
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza like illness
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: doxycline
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0612USA01119

Write-up: Initial and follow up information has been received from a Registered Nurse concerning a white female patient who on the morning of 10-Aug-2006 was vaccinated IM with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. Concomitant medication included doxycline. No medical attention was sought. Within a day or two, the patient recovered. Additional information has been requested. Follow up information indicated that the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


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