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This is VAERS ID 276694

Case Details

VAERS ID: 276694 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-01-12
Onset:2007-01-12
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:90
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: Amenorrhoea
SMQs:, Fertility 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA03292

Write-up: Information has been received from a licensed practical nurse concerning a 12 year old female who on 12-JAN-2007 was vaccinated with a first dose of Gardasil and a second dose on 12-MAR-2007. The patient''s mother reported to the nurse her daughter did not get a period in January 2007 but she in February 2007 and she is not pregnant. Additional information has been requested.


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