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This is VAERS ID 279497

Case Details

VAERS ID: 279497 (history)  
Form: Version 1.0  
Age: 26.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-11-14
Onset:2006-11-15
   Days after vaccination:1
Submitted: 2007-05-14
   Days after onset:179
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 - / -

Administered by: Other       Purchased by: Other
Symptoms: Adnexa uteri pain, Nausea, Pain, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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: Ortho Tri Cyclen
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0704USA04225

Write-up: Information has been received from a registered nurse concerning her 26 year old female daughter who on 14-NOV-2006 was vaccinated with the first dose of Gardasil, injection, 0.5 ml. Concomitant therapy included Ortho Tri-Cyclen. On 15-NOV-2006 the following day after receiving the first dose of Gardasil, the patient experienced nausea, vomiting and severe ovary aches. On 12-DEC-2006, the second dose of Gardasil, the patient experienced nausea, vomiting and severe ovary aches. The third dose of Gardasil was received on 13-APR-2007. On 14-APR-2007, the patient experienced nausea, vomiting and the patient has recovered from the events. Additional information has been requested.


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