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This is VAERS ID 282370

Case Details

VAERS ID: 282370 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Female  
Location: Texas  
   Days after vaccination:44
Submitted: 2007-06-19
   Days after onset:76
Entered: 2007-06-20
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Abortion spontaneous, Drug exposure during pregnancy
SMQs:, Pregnancy, labour and delivery complications and risk factors (excl abortions and stillbirth) (narrow), Termination of pregnancy and risk of abortion (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: ORTHO TRI-CYCLEN LO
Current Illness: Pregnancy NOS (LMP = 4/4/2007)
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA01990

Write-up: Information has been received from a registered nurse concerning a 20 year old female with no relevant medical history who on 19-FEB-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 653735/0688F). Concomitant therapy included Ortho Tri-Cyclen Lo. Subsequently, she became pregnant. Date of LMP was 04-APR-2007. The patient subsequently miscarried. The patient was seen in the emergency room on 14-MAY-2007 for the miscarriage. She was not admitted to the hospital. The patient called the office on 17-MAY-2007 to notify the physician of the miscarriage, but had not returned to the office for follow-up visits. Upon internal review, the patient''s spontaneous abortion was considered an other important medical event. Additional information has been requested.

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