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This is VAERS ID 284257

Case Details

VAERS ID: 284257 (history)  
Age: 10.0  
Gender: Female  
Location: California  
Vaccinated:2006-10-03
Onset:2006-10-04
   Days after vaccination:1
Submitted: 2007-07-10
   Days after onset:279
Entered: 2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB124AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Influenza like illness, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: None
CDC Split Type:

Write-up: This is report # 1 of 3, one for each Gardisil administered. Mother stated to me on 05/18/07, that 24 hours after Gardisil vaccine, patient had fever, and then developed flu-like symptoms.


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