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This is VAERS ID 276690

Case Details

VAERS ID: 276690 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Kentucky  
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:30
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 1 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Dizziness, Headache
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL TABLETS
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA03133

Write-up: Information has been received from a registered nurse concerning a 17 year old female with no pertinent medical history or drug reactions/allergies who on 14-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (0.5 ml) (lot # 656049/0187U). Concomitant therapy included Adderall tablets. On approximately 15-MAR-2007, the patient experienced headache and abdominal pain. Unspecified medical attention was sought, At the time of this report, the outcome of the events was unknown. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 4/13/2007. Immediately after the vaccine was administered, the patient felt dizzy and three hours later, the patient experienced abdominal pain. The patient also experienced headache. The dizziness subsided after 30 minutes, and subsequently, the patient recovered from the abdominal pain. Additional information has been requested.

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