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This is VAERS ID 283736

Case Details

VAERS ID: 283736 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Oklahoma  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Blood urine present, Laboratory test normal, Ultrasound scan normal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Haemorrhage laboratory terms (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: diagnostic laboratory no UTI or kidney infection; ultrasound no UTI or kidney infection
CDC Split Type: WAES0705USA00404

Write-up: Information has been received from a nurse concerning a female with an allergy to aluminum hydroxyphosphate who was vaccinated with Gardasil. The patient developed blood in urine after receiving her second dose. It was unknown if she had any problems after her first dose. An ultrasound and tests to rule out urinary tract infection and kidney infection were performed. The patient did not have a kidney or urinary tract infection. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a nurse concerning a female with an allergy to aluminum hydroxyphosphate who was vaccinated with Gardasil. The patient developed blood in urine after receiving her second dose. It was unknown if she had any problems after her first dose. An ultrasound and tests to rule out urinary tract infection and kidney infection were performed. The patient did not have a kidney or urinary tract infection. At the time of this report, the patient''s outcome was unknown. Additional information has been requested.


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