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This is VAERS ID 276824

Case Details

VAERS ID: 276824 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-15
Onset:2007-03-15
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:29
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0703USA03736

Write-up: Information has been received from a physician concerning a 13 year old female who on 15-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (Lot# not reported). Concomitant therapy included tetanus toxoid (manufacturer unknown). On 16-MAR-2007 the patient called her physician office and reported that at an unspecified time on 15-MAR-2007 post vaccination she developed dizziness, vomiting and a fever (actual temperature not reported). Unspecified medical attention was sought. The patient has not contacted the physician again.


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