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This is VAERS ID 276891

Case Details

VAERS ID: 276891 (history)  
Age: 15.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-03-22
Onset:2007-03-22
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:22
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Dizziness, Wrong drug administered
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unk
CDC Split Type: WAES0703USA04708

Write-up: Information has been received from a physician, concerning a 15 year old female patient, who on 22-MAR-2007 was vaccinated with the first dose of Gardasil. Concomitant vaccine administration included DTaP (manufacturer unspecified) and a third vaccine [therapy unspecified]. On approximately 22-MAR-2007 the patient experienced dizziness. At the time of this report, the patient''s dizziness persisted. The patient sought unspecified medical attention. Additional information has been requested.


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