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This is VAERS ID 279645

Case Details

VAERS ID: 279645 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-01
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 - / -

Administered by: Other       Purchased by: Other
Symptoms: Alopecia
SMQs:

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:
CDC Split Type: WAES0704USA06706

Write-up: Information has been received from a physician concerning a 20 year old female who in March 2007 was vaccinated with Gardasil. Subsequently the patient experienced hair loss. The patient''s hair loss persisted. Additional information has been requested.


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