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This is VAERS ID 276248

Case Details

VAERS ID: 276248 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Illinois  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:105
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Hot flush, Immediate post-injection reaction, Injection site pain, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA04432

Write-up: Information has been received from a registered nurse concerning a 20 year old female student who on 21-DEC-2006, at 2:00PM, was vaccinated IM, into the left deltoid, with a first dose of Gardasil (Lot# 653937/0637F). There was no illness at the time of vaccination. On 21-DEC-2006, after the injection, at 2:00PM, the patient became lightheaded and nauseated, "approximately 15 minutes". The nurse also reported the injection was very painful when vaccine contents injected into muscle and the patient had a hot flash. On 23-FEB-2007, at 3:15PM, the patient was vaccinated IM, into the left deltoid, with a second dose of Gardasil (Lot# 654389/0961F). There was no illness at the time of vaccination. The nurse reported that the patient felt a hot flash immediately post injection . The second injection was also said to be very painful when vaccine contents injected into the muscle (not from needle placement), for "five minutes". No further information is expected.


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