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This is VAERS ID 271165

Case Details

VAERS ID: 271165 (history)  
Age: 12.0  
Gender: Female  
Location: Texas  
Vaccinated:2006-12-01
Onset:0000-00-00
Submitted: 2007-01-16
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Amenorrhoea
SMQs:, Fertility disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC Split Type: WAES0701USA00223

Write-up: Information has been received from a physician concerning a 12 year old female who on 01-Dec-2006 was vaccinated with the first dose of Gardasil vaccine (yeast) (lot# not provided).On unspecified date in December, 2006, the patient separate two periods (dates not provided). The patient sought unspecified medical attention. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


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