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This is VAERS ID 274729

Case Details

VAERS ID: 274729 (history)  
Age: 14.0  
Gender: Female  
Location: Indiana  
Vaccinated:2006-12-27
Onset:2007-02-27
   Days after vaccination:62
Submitted: 2007-03-14
   Days after onset:14
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / UN

Administered by: Private       Purchased by: Other
Symptoms: Anaemia, Dizziness, Full blood count, Haematocrit decreased, Haemoglobin normal, Menorrhagia, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Haematopoietic erythropenia (broad), Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA
Current Illness: Allergy to wool
Preexisting Conditions:
Diagnostic Lab Data: hemoglobin 01?/??/07 10.8, complete blood cell 01?/??/07, hematocrit 01?/??/07 31.7; complete blood count, 02/23/07; hemoglobin, 02/23/07, 10.8; hematocrit, 02/23/07, 31.7; hemoglobin, 03/14/07, 11.3; hematocrit, 03/14/07, 34.3
CDC Split Type: WAES0703USA00057

Write-up: Information has been received from a nurse practitioner (NP) concerning a 14 year old female patient with an allergy to wool, who on 27-DEC-2006 was vaccinated with a dose of Gardasil (Lot # 653735/0688F). Concomitant therapy included DEPO-PROVERA, also administered on 27-DEC-2006. In approximately December 2006 ("since vaccination"), the patient "experienced anemia, dizziness, and heavy menstrual cycles." The NP also stated that the patient reported she "felt like she was going to pass out, but did not report passing out." The NP added that the "patient is receiving iron to treat the anemia." Diagnostic labs were performed (date not specified) including a complete blood count (CBC) (result not provided), hemoglobin 10.8 (unit not provided), and hematocrit 31.7 (unit not provided). At the time of this report, the patient had not recovered. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 3/14/2007. Initial and follow up information has been received from a registered nurse practitioner (NP) concerning a 14 year old female with an allergy to wool, who on 27-DEC-2006 (previously reported as 21-NOV-2006) was vaccinated in the right deltoid, with the first dose of GARDASIL (Lot # 653735/0688F). Concomitant therapy included DEPO-PROVERA, also adminsitered at the same visit. There was no illness at the time of vaccination. On 27-FEB-2007 (previously reported as December 2006, 01-FEB-2007 or "since vaccination"), the patient "experienced anemia, dizziness, and heavy menstrual cycles". The NP also stated that the patient reported she "felt like she was going to pass out, but did not report passing out". The NP added that the "patient is receiving iron to treat the anemia". Diagnostic labs were performed on 23-FEB-2007 including a complete blood count (result not provided), hemoglobin 10.8 (unit not provided), and hematocrit 31.7 (unit not provided). Follow up information received from the nurse practitioner indicated that the patient had also been experiencing lightheadedness. On 14-MAR-2007, additional labs were drawn; hemoglobin 11.3 and hematocrit 34.3 (units not specified). The NP confirmed that the patient had recovered from the events, with the exception of the anemia, which is improving. The patient continues to be treated, and the nurse practitioner added that the patient and her mother feel the anemia was "due to GARDASIL". No further information is expected.


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