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This is VAERS ID 286246

Case Details

VAERS ID: 286246 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Florida  
Vaccinated:2007-06-08
Onset:2007-07-17
   Days after vaccination:39
Submitted: 2007-07-23
   Days after onset:6
Entered: 2007-07-30
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 14290 / 1 LA / IJ

Administered by: Private       Purchased by: Private
Symptoms: Abortion spontaneous, Endocervical curettage, Pregnancy test positive, Ultrasound uterus, Uterine dilation and curettage
SMQs:, Termination of pregnancy and risk of abortion (narrow), Normal pregnancy conditions and outcomes (narrow)

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

Write-up: Pt was give Gardasil shot June 8-Had positive preg. test June 21. U/S 2 months baby heart beating 2nd U/S no heart beat (7/17 d/c to remove deceased baby) at medical center


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