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This is VAERS ID 272326

Case Details

VAERS ID: 272326 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: New York  
   Days after vaccination:3
Submitted: 2007-02-14
   Days after onset:130
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Vaccine positive rechallenge, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA01772

Write-up: Information has been received from a registered nurse concerning a 16 year old female with an aspirin allergy who on 04-OCT-2006 at 16:00 and 11-DEC-2006 at 14:30 was vaccinated IM into the right deltoid with a first and second dose of Gardasil (first dose lot #653736/0689F, second dose lot #654510/0962F). Concomitant therapy given on 04-OCT-2006 and 11-DEC-2006 included a dose of Havrix. Three days after the first dose, the patient vomited for 2 days and was out of school. Three days after the second dose the patient threw up a lot more for 2 days and was out of school. The nurse was concerned about this patient and considered her condition to be disabling since she missed school for two days after each dose. Unspecified medical attention was sought. No diagnostic laboratory studied were performed. No product quality complaint was involved. Additional information is not expected.

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