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This is VAERS ID 284557

Case Details

VAERS ID: 284557 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-11-01
Onset:2006-11-01
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:224
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: Asthenia, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Lactose intolerance
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0706USA00038

Write-up: Information has been received from a certified nurse midwife concerning a 21 year old female with lactose intolerance who in November 2006, was vaccinated with a first dose of Gardasil. There were no concomitant medications. Subsequently, 12 to 24 hours after the first, the patient experienced "extreme weakness" and fever $g 100 F. Unspecified medical attention was sought. Subsequently, the patient recovered from "extreme weakness" and fever $g 100 F. On an unspecified date, the patient was vaccinated with a second dose of Gardasil. Subsequently, 12 to 24 hours after the second, the patient experienced "extreme weakness" and fever $g 100 F. Unspecified medical attention was sought. Subsequently, the patient recovered from "extreme weakness" and fever $g 100 F. Additional information has been requested.


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