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This is VAERS ID 276240

Case Details

VAERS ID: 276240 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New York  
   Days after vaccination:1
Submitted: 2007-04-06
   Days after onset:35
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: Public
Symptoms: Diarrhoea, Dizziness, Eye haemorrhage, Fatigue, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Retinal disorders (broad), Vestibular disorders (broad), Noninfectious diarrhoea (narrow)

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
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA01943

Write-up: This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow up information has been received from an office receptionist and a nurse practitioner(N.P.) concerning her 17 year old step daughter who on 28-FEB-2007, at 2:30 PM was vaccinated in the left arm with a first dose of GARDASIL lot #654535/0960F. The patient experienced extreme nausea, diarrhea and dizziness after the injection. "Patient was vomiting so hard, that the blood vessels in her eyes broke." The patient''s outcome was unknown. In follow-up it was indicated that patient started vomiting on 01-MAR-2007 at 03:00 AM and vomited 8 times. She broke blood vessels in both eyes. Her diarrhea continued for 24 hours and she was very tired, slept a lot and missed 2 days of school. On 03-MAR-2007 patient recovered. Additional information is not expected.

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