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This is VAERS ID 279042

Case Details

VAERS ID: 279042 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Maryland  
Vaccinated:2007-02-20
Onset:2007-02-20
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:82
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Arthritis, Dizziness, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Arthritis (narrow)

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA00395

Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 15 year old female patient who on 20-FEB-2007 was vaccinated with her first 0.5 mL dose of Gardasil in the left arm. On 26-FEB-2007, the patient called the office complaining of nausea, vomiting, dizziness and arthritic like symptoms. Laboratory evaluation revealde normal CBC, ANA, and RA. She was seen in the office on 28-MAR-2007 and was limping. Follow-up on 27-APR-2007 indicated that the patient was doing better, but still had hip discomfort. It was noted that the injection was not administered in the hip. Additional information has been requested.


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