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This is VAERS ID 277188

Case Details

VAERS ID: 277188 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-03-30
Onset:2007-03-30
   Days after vaccination:0
Submitted: 2007-03-30
   Days after onset:0
Entered: 2007-04-23
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 UN / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Fluoride
Current Illness: Type II Diabetes
Preexisting Conditions: No known drug allergies, just diagnosed with Type II Diabetes
Allergies:
Diagnostic Lab Data: No test performed at the office on 3-30-07.
CDC Split Type: TX07027

Write-up: 3/30/07 10:00 AM HPV vaccine was administered on her left upper arm sitting on an exam table. 2-3 minutes after administering vaccine, pt. c/o a headache and dizziness. Pt. was placed on exam table in a laying position.


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