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This is VAERS ID 274573

Case Details

VAERS ID: 274573 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Michigan  
Vaccinated:2007-01-11
Onset:2007-01-11
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:61
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0702USA03905

Write-up: Information has been received from a nurse, via a company representative, concerning a 13 year old female patient who on 11-JAN-2007 was vaccinated with the first dose, 0.5ml, IM of HPV. The nurse reported that the patient had developed vaginal bleeding that had "varied from light to heavy and has been continuous since the date of administration." The nurse reported that the patient had been referred to an OBGYN for further evaluation. At the time of this report, the patient had not recovered. Additional information has been requested.


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