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This is VAERS ID 276109

Case Details

VAERS ID: 276109 (history)  
Form: Version 1.0  
Age: 38.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:73
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Fatigue, Ocular hyperaemia
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Glaucoma (broad), 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: Colitis ulcerative
Diagnostic Lab Data: None
CDC Split Type: WAES0701USA04534

Write-up: Information has been received from a nurse practitioner concerning a 38 year old female with colitis ulcerative and no allergies who on 22, Jan 2007 was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 22, Jan 2007 the patient had eye redness of the white of the eye, tiredness, fatigue and lightheadedness. As of 05, Feb 2007, the patient''s symptoms continued. Additional information has been requested.

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