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This is VAERS ID 284495

Case Details

VAERS ID: 284495 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Indiana  
   Days after vaccination:5
Submitted: 2007-06-14
   Days after onset:71
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Anogenital warts

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: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0705USA05187

Write-up: Information has been received from a pharmacist and the patient''s mother concerning a 12 year old female who on 29-JAN-2007 was vaccinated with the first dose of Gardasil. On 30-MAR-2007 the patient received a second dose of Gardasil. On 04-APR-2007 the patient was diagnosed with genital warts. The patient had no other symptoms. Additional information has been requested.

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