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This is VAERS ID 284528

Case Details

VAERS ID: 284528 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Unknown  
Vaccinated:0000-00-00
Onset:2007-02-01
Submitted: 2007-06-14
   Days after onset:132
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Frostbite, Hypoaesthesia, Skin discolouration
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Accidents and injuries (broad), Hypotonic-hyporesponsive episode (broad)

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: (therapy unspecified), NECON
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA05702

Write-up: This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a Nurse Practitioner concerning a 14 year old female with no history of drug reactions/allergies and a history of asthma who on an unspecified date was vaccinated with Gardasil. Concomitant therapy included several other unspecified vaccines concomitantly and Necon. Subsequently on an unspecified date the patient developed frostbite of the toes/foot. The frostbite occurred some time in February in 40 degree weather outdoors at a football game with socks and shoes. The patient was still experiencing numbness and discoloration of toes. The vaccination was administered at another unspecified practice. The patient sought unspecified medical attention but did not undergo lab tests. As of 30-MAY-2007 the patient was recovering. Additional information has been requested. Further information is not available.


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