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This is VAERS ID 279523

Case Details

VAERS ID: 279523 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Missouri  
Vaccinated:2007-03-09
Onset:2007-03-09
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:65
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Influenza like illness, Malaise, Nausea
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Patent ductus arteriosus repair
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA04661

Write-up: initial and follow up information has been received from a physician, concerning his 16 year old daughter, with a history of patient ductus arteriosis (PDA) ligation who on 11-JUL-2006 was vaccinated with the first dose of Gardasil, on 23-Oct-2006, with the second dose of Gardasil and on 06-APR-2007 was vaccinated, IM, with the third dose of Gardasil. The physician reported that on 07-APR-2007, the day following the vaccination, his daughter experienced flu-like symptoms, was extremely nauseated, and had severe malaise that lasted for three to four days after the vaccine had been administered and then recovered (approximately 12-MAR-2007). The patient''s sister also experienced flu-like symptoms and nausea and malaise after vaccination with Gardasil (WAES #0704USA05005). Additional information is not expected.


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