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This is VAERS ID 284161

(NOTE: This result is from the 4/7/2010 version of the VAERS database)

Case Details

VAERS ID: 284161 (history)  
Form: Version .0  
Age: 17.0  
Gender: Female  
Location: California  
Vaccinated:2007-05-09
Onset:2007-05-09
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:36
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1161F / 0 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Asthenia, Dizziness
SMQs:, Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Vestibular 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: SYNTHROID
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03821

Write-up: Information has been received from a physician, via a company representative, concerning an 18 year old female patient who was vaccinated with the first dose (date and dose unspecified) of Gardasil. The physician reported her approximately 3 hours after the vaccination was administered, the patient called and stated she had experienced some dizziness. At the time of this report, it was unknown if the patient had recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a physician, via a company representative, concerning a 17 year old (previously reported as 18 year old) female patient who on 09-MAY-2007, was vaccinated from a pre-filled syringe, with the first dose of GARDASIL (Lot #654540/1161F). Concomitant therapy included SYNTHROID; there were no concomitant vaccines administered. The physician reported that approximately 3 to 4 hours after the vaccination was administered, the patient began to feel weak and dizzy, and had to lie down; she recovered within several hours. The physician clarified that the patient had not consulted the office at the time of the event, but later reported it at a return visit to the office. At the time of this report, it was confirmed that the patient had fully recovered. No further information is expected.


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http://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20100407&IDNUMBER=284161


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