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This is VAERS ID 276696

Case Details

VAERS ID: 276696 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-07
Onset:2007-03-07
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:36
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad)

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: Unknown
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0703USA03394

Write-up: Information has been received from a physician concerning a 14 year old female who on 07-MAR-2007 was vaccinated with the first dose of 0.5ml of Gardasil IM. During the same visit, the patient was vaccinated with hepatitis A vaccine (inactive) (duration and dose not reported). The patient returned to the office 4 hours after her appointment complaining of dizziness. The patient was monitored for 1 hour. During that time, the patient recovered from dizziness and was sent home. No lab testing was performed. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/13/2007. In follow-up, it was reported there were no further details to provide. Additional information is not expected.


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