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This is VAERS ID 283319

Case Details

VAERS ID: 283319 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Missouri  
Vaccinated:2007-06-19
Onset:2007-06-20
   Days after vaccination:1
Submitted: 2007-06-25
   Days after onset:5
Entered: 2007-06-29
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0524U / 3 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Cough, Nasal congestion, Sinusitis, Upper respiratory tract infection
SMQs:, Anaphylactic reaction (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: URI~HPV (Gardasil)~2~0.00~In Patient
Other Medications: Yaz birth control pill
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Nasal congestion and cough 1-2 days after vaccine x 3 - Dx URI/ Sinusitis, Treatment Z-Pak.


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