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This is VAERS ID 279539

Case Details

VAERS ID: 279539 (history)  
Form: Version 1.0  
Age: 14.0  
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 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Influenza like illness, Malaise, Nausea, Vaccine positive rechallenge
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
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA05005

Write-up: This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a physician, via a company representative, concerning the physician''s daughter, age 15 or 16 years, who on approximately 09-MAR-2007 ("about six weeks ago") was vaccinated, IM, with the third dose Gardasil. The physician reported that following the vaccination, his daughter experienced flu-like symptoms and nausea, that lasted for three days after the vaccine had been administered, approximately 12-MAR-2007. The physician confirmed that following the three days, his daughter was "fine." The patient''s sister also experienced flu-like symptoms and nausea after vaccination with Gardasil (WAES#0704USA04661). Additional information has been requested. Initial and follow up information has been received from a physician, concerning his 14 year old daughter, who on 31-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 11-MAR-2007). The patient''s sister also experienced flu-like symptoms, nausea and malaise after vaccination with GARDASIL (WAES #0704USA04661). Additional information is not expected.


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