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This is VAERS ID 276667

Case Details

VAERS ID: 276667 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Colorado  
Vaccinated:2007-03-12
Onset:2007-03-12
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:32
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Blood human chorionic gonadotropin negative, Menstruation irregular, Pregnancy test negative, Smear cervix normal
SMQs:, Fertility disorders (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: DEPO-PROVERA mg
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Cervical smear - Normal, Beta-human chorionic - negative
CDC Split Type: WAES0703USA02355

Write-up: Information has been received from a healthcare worker concerning a 24 year old female who on 12-MAR-2007 was vaccinated IM 0.5ml first dose of Gardasil (lot# 655617/1447F). Concomitant therapy included DEPO-PROVERA lasted administered 12-Feb-2007. On 12-MAR-2007 the patient experienced induced period 2 hours after receiving Gardasil. Her previous period was 12-Feb-2007 so the nurse believes Depo is not working properly. The patient had the following lab diagnostics studies performed: Pap smear was normal and pregnancy test was negative. The patient sought unspecified medical attention. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 4/13/2007. Information has been received from a healthcare worker concerning a 24 year old female with no medical history or allergies, who on 12-MAR-2007 was vaccinated IM with a first 0.5ml dose of GARDASIL (lot# 655617/1447F). Concomitant therapy given the same day included DEPO-PROVERA last administered 12-Feb-2007. There was no illness at the time of vaccination. On 12-MAR-2007 the patient developed an induced period 2 hours after receiving GARDASIL. Her previous period was 12-Feb-2007 so the nurse believes DEPO was not working properly. The patient had the following lab diagnostics studies performed: Pap smear was normal and pregnancy test was negative. The patient sought unspecified medical attention. At the time of this report, the patient recovered. Additional information is not expected.


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