National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 283791

Case Details

VAERS ID: 283791 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-15
Onset:2007-01-15
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:149
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 LA / UN

Administered by: Private       Purchased by: Other
Symptoms: Dizziness, Pain in extremity
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (broad), Tendinopathies and ligament disorders (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:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA01682

Write-up: Information has been received from a physician''s assistant concerning a 17 year old white female (132 lbs, 5''4") with an amoxicillin allergy who on 15-JAN-2007 was vaccinated by a nurse with Gardasil, lot # 655617/1447F in the left arm. On 15-JAN-2007 the patient experienced severe dizziness and arm pain for 2 days. On 18-JAN-2007 the patient recovered. No treatment was sought. Additional information has been requested. Initial and follow up information has been received frm a physician''s assistant concerning a 17 year old female with an AMOXICILLN allergy who on 15-JAN-2007 was vaccinated by a nurse with GARDASIL, lot # 655617/1447F in the left upper arm. The patient had no known illnesses at the time of vaccination. On 15-JAN-2007 the patient experinced severe dizziness and arm pain for 2 days. On 18-JAN-2007 the patient recovered.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283791


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166