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This is VAERS ID 279066

Case Details

VAERS ID: 279066 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-17
Onset:2007-03-17
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:58
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Immediate post-injection reaction, Injection site pain, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0704USA00868

Write-up: Information has been received from a nurse concerning her 15 year old daughter who on 17-MAR-2007 was vaccinated with a dose of Gardasil, IM. Concomitant medication was not reported. On 17-MAR-2007, the patient experienced pain at the injection site immediately after vaccination with Gardasil. The pain resolved by the end of the day. On 20-MAR-2007 (three days later), the pain came back and it was associated with nausea and fever. The patient sought unspecified medical attention. It was also mentioned that no other vaccinations were administered that day. The symptoms resolved after an unspecified time. Additional information has been requested.


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