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This is VAERS ID 276829

Case Details

VAERS ID: 276829 (history)  
Age: 13.0  
Gender: Female  
Location: California  
Vaccinated:2007-03-15
Onset:2007-03-19
   Days after vaccination:4
Submitted: 2007-04-13
   Days after onset:25
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / - UN / UN

Administered by: Private       Purchased by: Public
Symptoms: Menorrhagia, Tuberculin test
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unk Tuberculin purified protein derivative
CDC Split Type: WAES0703USA03790

Write-up: Initial and follow up information has been received from a physician and a health care professional concerning a 13 year old female patient who on 15-MAR-2007 at 04:30 PM was vaccinated IM with a first dose of GARDASIL vaccine, lot #654510/0962F. Concomitant therapy included ADACEL, MENACTRA and tuberculin purified protein derivative. On 19-MAR-2007 the patient developed an off cycle additional menstrual cycle with a heavy flow. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Additional information has been requested.


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