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This is VAERS ID 279218

Case Details

VAERS ID: 279218 (history)  
Age: 15.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-12
Onset:2007-04-13
   Days after vaccination:1
Submitted: 2007-05-14
   Days after onset:31
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Breast pain
SMQs:, Guillain-Barre syndrome (broad), Lipodystrophy (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA INJECTION
Current Illness: Contraception
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA02738

Write-up: Information has been received from a health professional concerning a 15 year old female who on 12-APR-2007 was vaccinated with Gardasil. Concomitant therapy included Depo-Provera Injection for birth control. On 13-APR-2007 after receiving her first dose of the vaccine, the patient experienced soreness in her breasts and weakness. It was reported that the patient received unspecified medical attention. No further information is available. Additional information has been requested.


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