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This is VAERS ID 279524

Case Details

VAERS ID: 279524 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Missouri  
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:38
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       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: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA04710

Write-up: Information has been received from a physician concerning a 15 year old, (previously reported as a 16 year old), white female student, who on 09-AUG-2006 in the pm. was vaccinated with the first dose of Gardasil in the right arm. On 03-NOV-2006 in the pm. was vaccinated with the second dose of Gardasil in the left arm. On 23-FEB-2007 in the pm. was vaccinated with the third dose of Gardasil in the right arm (previously reported left arm) it was reported at the time of the vaccine the patient had nausea and severe malaise. Unspecified medical attention was sought. On approximately 27-APR-2007, the patient recovered from flu like symptoms extreme nausea, and severe malaise. Additional information is not expected.

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