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This is VAERS ID 276642

Case Details

VAERS ID: 276642 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-04-13
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Anxiety, Insomnia, Mental disorder
SMQs:, Dementia (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
CDC Split Type: WAES0703USA01474

Write-up: Information has been received from a dentist concerning his daughter a 16 year old female who on an unspecified date in approximately February 2007, was vaccinated with the first dose of Gardasil (Yeast) (lot# not provided). Subsequently, "within one week of vaccination" the patient developed extreme anxiety, sleeplessness and was in a "bad psychological state". The patient was seen by a counselor for unspecified treatment. The patient was said to be recovering on an unspecified therapy. Additional information has been requested.


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