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This is VAERS ID 283804

Case Details

VAERS ID: 283804 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-03-05
Onset:2007-03-07
   Days after vaccination:2
Submitted: 2007-06-14
   Days after onset:98
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 1 RA / UN

Administered by: Private       Purchased by: Private
Symptoms: Menstruation irregular
SMQs:, Fertility 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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02020

Write-up: Information has been received from a physician and an LPN concerning a 14 year old female who on 05-MAR-2007 at 10:45 a.m. was vaccinated in the right deltoid with the first 0.5 mL dose of Gardasil (lot# 655619/1427F). Concomitant vaccination given in the right deltoid on 05-MAR-2007 included MENACTRA (lot # U1947AA). It was reported that the patient was vaccinated on day 4 of her menses. Her menses stopped for 2 days and re-started on 07-MAR-2007 and continued through 13-MAR-2007 (described as a normal cycle. During this time she had normal cramps and no treatment was given. Her cycle returned to normal occurring 28 days later. The patient reported that she is on a normal 28-day menstrual cycle since the age of 13 years. The patient was not on birth control. No further information is expected.


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