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This is VAERS ID 279484

Case Details

VAERS ID: 279484 (history)  
Age:   
Gender: Female  
Location: Wisconsin  
Vaccinated:0000-00-00
Onset:2006-12-01
Submitted: 2007-05-14
   Days after onset:163
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Menstrual disorder
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Unknown
Preexisting Conditions: Borderline mental impairment
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA03900

Write-up: Information has been received from a registered nurse concerning a female (age not reported) which borderline mental retardation who on an unspecified date was vaccinated with a first dose of Gardasil. On an unspecified date, the patient was vaccinated with a second dose of Gardasil (lot # not reported) 0.5 ml injection. In December 2006, the patient experienced an interruption of her menstrual cycle after receiving the second dose of vaccine. The patient sought medical attention. At the time of reporting, the patient had not recovered. No further information was provided at the time of reporting. Additional information has been requested.


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