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This is VAERS ID 271136

Case Details

VAERS ID: 271136 (history)  
Form: Version 1.0  
Age: 53.0  
Gender: Male  
Location: Unknown  
Vaccinated:2006-11-22
Onset:2006-11-22
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:55
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK MO / PO

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Liver disorder
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA03152

Write-up: Information has been received from a consumer concerning her 53 year old father with liver problems and no drug allergies who on 22-NOV-2006 inadvertently received HPV rL1 6 11 16 18 VLP vaccine (yeast) (0.5 ml), orally. There was no concomitant medication. Subsequently, "in late November" the patient experienced nausea, dizziness and weakness. At the time of the report, the patient had not recovered. There were no relevant diagnostic tests or laboratory data. Additional information is not expected.


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