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This is VAERS ID 283747

Case Details

VAERS ID: 283747 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-05-02
Onset:2007-05-02
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:43
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: Private       Purchased by: Other
Symptoms: Abdominal pain upper, Dizziness, Headache, Nausea, Vision blurred
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA00643

Write-up: Information has been received from a registered nurse (school nurse), via an agency, concerning a 17 year old female student, who at 9:00am on 02-MAY-2007 was vaccinated with a dose of Gardasil. Thirty minutes after the vaccine was administered, the patient experienced nausea, dizziness, headache, stomach ache and blurred vision. The patient reported to the school nurse, who made the call to the agency to question if the symptoms had been previously reported after vaccination with Gardasil. At the time of this report, four and one half hours after receiving the vaccination, the patient had not recovered and was referred to her primary physician. Additional information has been requested.


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