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This is VAERS ID 283812

Case Details

VAERS ID: 283812 (history)  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-09
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. 0263U / 0 UN / IM

Administered by: Private       Purchased by: Other
Symptoms: Alopecia
SMQs:

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Singulair
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0705USA02074

Write-up: Information has been received from a physician concerning a female (age not reported) with pertinent medical history and drug reactions/allergies reported as none who on 09-MAR-2007 was vaccinated with the first dose of Gardasil (lot #655849/0263U), 0.5 ml, IM in the deltoid. Concomitant therapy included montelukast sodium (MSD). Subsequently on an unspecified date, the patient experienced hair loss after her first dose of Gardasil. The patient sought unspecified medical attention. The patient''s hair loss persisted. Additional information has been requested.


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