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This is VAERS ID 279507

Case Details

VAERS ID: 279507 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-04-19
Onset:0000-00-00
Submitted: 2007-05-14
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: Other       Purchased by: Other
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular disorders (broad)

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: WAES0704USA04413

Write-up: Information has been received from a physician concerning a 13 year old female patient who on 19-APR-2007 was vaccinated with a dose of Gardasil. Patient developed dizziness and weakness after the vaccine was administered. Unspecified medical attention was sought was unknown. Additional information has been requested.


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