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This is VAERS ID 279643

Case Details

VAERS ID: 279643 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Indiana  
Vaccinated:2007-04-24
Onset:2007-04-24
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:20
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 2 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Flushing, Hyperhidrosis
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Vestibular disorders (broad), Hypersensitivity (broad), Hypoglycaemia (broad)

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: WAES0704USA06677

Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 13 year old female patient who on 19-FEB-2007 was vaccinated IM a first dose of with Gardasil lot #653736/0689F and on 24-APR-2007 she was vaccinated IM with a second dose of Gardasil lot # 655849/0263U. She became dizzy and flushed with sweating within minutes after her second injection was given. She quickly recovered. Additional information has been requested. Additional information is not exepcted.


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