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This is VAERS ID 276229

Case Details

VAERS ID: 276229 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: New York  
Vaccinated:2006-10-13
Onset:2006-10-13
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:175
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Diarrhoea, Dizziness, Dyskinesia, Fatigue, Injection site pruritus, Injection site swelling, Muscular weakness, Nausea, Tremor, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Dyskinesia (narrow), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Vestibular disorders (broad), Noninfectious diarrhoea (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01300

Write-up: Information has been received from an office receptionist concerning her 19 year old daughter who on an unspecified date was vaccinated with a first dose of Gardasil. The patient''s arm was "shaky" after the first injection. On an unspecified date the patient received her 2nd dose of Gardasil. Subsequently, her arm was "jumpy" and she experienced vomiting and diarrhea. Unspecified medical attention was sought. The patient recovered. Additional information has requested. 07/06/07 This is in follow-up to report(s) previously submitted on 4/6/2007. Follow up information has been received froma health professional concerning a 19 year old female who on 13-OCT-2006, AM was vaccinated IM in right arm with a first dose of GARDASIL lot #653978/0955F and on 02-JAN-2007, AM she received IM in to right arm the second dose of GARDASIL lot #653978/0955F. After first vaccination in October 2006, the patient experienced itchy and swollen at injection site. In approximately January 2007, at 6:00 PM patient was dizzy, very tired, had nausea and her arm was shaking and had arm weakness. Her hand would jump by itself once in a while. She was fine the next day. The patient recovered. No additional information is expected.


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