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This is VAERS ID 276941

Case Details

VAERS ID: 276941 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-20
Onset:0000-00-00
Submitted: 2007-04-13
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 2 LA / 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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA00180

Write-up: Information has been received from a consumer concerning her 15 year old daughter, with no pertinent medical history, who in January 2007, was vaccinated with a 0.5 ml dose of Gardasil. There was no concomitant medication. Subsequently the patient experienced "some dizziness while taking" Gardasil. It was reported that the patient did not seek medical attention. On an unspecified date, the patient recovered. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 4/13/2007. Information has been received from a physician and a consumer concerning her 15 year old daughter, with no pertinent medical history, who on 20-DEC-2006 was vaccinated intramuscularly, into the left deltoid, with a 0.5 ml second dose of GARDASIL (lot #653978/0955F). There was no concomitant medication. In late March it was reported by phone that the patient felt dizzy and lightheaded. It was reported that the patient did not seek medical attention. On an unspecified date, the patient recovered. No further information is available.


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