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This is VAERS ID 269687

Case Details

VAERS ID: 269687 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Missouri  
Vaccinated:2006-12-11
Onset:2006-12-11
   Days after vaccination:0
Submitted: 2006-12-18
   Days after onset:7
Entered: 2006-12-27
   Days after submission:9
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 RL / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Dizziness, Nausea, Tremor
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: blood pressure 12/11/2006 - 100/52
CDC Split Type: WAES0612USA02339

Write-up: 2:30 gave injection. 2:40 Patient complained of being dizzy and nauseous. Laid patient down with wet cloth on head, gave water. 2:50 took blood pressure 100/52. Patient complains of shakiness. 3:05 No better took to urgent care. This is in follow-up to report (s) previously submitted on 1/16/2007. Initial and follow-up information has been received from a health professional concerning an 17 year old female with no known allergies, who on 11-DEC-2006 at 2:30 PM was vaccinated intramuscularly in the right gluteal with the first dose of GARDASIL (lot # 653938/0954F). There were no illnesses at the time of vaccination. On 11-DEC-2006, at 2:40 PM, following vaccination, the patient complained of feeling dizzy, and nauseous (it was also reported that the patient felt weak). The patient did not faint. The patient laid down with a wet cloth on her head and was given water. At 2:50 PM, the patient''s blood pressure was noted to be 100/52 and the patient complained of shakiness. At 3:50 PM, the patient had not improved, and was taken to an urgent care facility. The patient was evaluated at the urgent care and released to home. The patient subsequently recovered on 11-DEC-2006. No further information is expected.


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