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This is VAERS ID 284156

Case Details

VAERS ID: 284156 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-05-17
Onset:2007-05-17
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:28
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Immediate post-injection reaction, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)

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: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA03778

Write-up: Information has been received from a physician concerning a 14 year old female patient with no known allergies who on 17-MAY-2007 was vaccinated IM with 0.5 ml of Gardasil. That same day, 5 minutes after the injection, she felt nauseous which lasted throughout the night and on 18-MAY-2007 she vomited. The patient sought unspecified medical attention. No further information is available. Additional information has been requested.


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