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This is VAERS ID 289665

Case Details

VAERS ID: 289665 (history)  
Form: Version 1.0  
Age: 20.0  
Sex: Female  
Location: Arizona  
Vaccinated:2007-05-01
Onset:2007-05-01
   Days after vaccination:0
Submitted: 2007-08-14
   Days after onset:105
Entered: 2007-08-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private       Purchased by: Private
Symptoms: Vaginal haemorrhage
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA04429

Write-up: Information has been received from a certified medical assistant concerning a 20 year old female, who in May-2007 was vaccinated with a first dose of Gardasil. Subsequently, the patient developed vaginal bleeding for about a month. On 23-JUL-2007 the patient was vaccinated intramuscularly with a 0.5mL second dose of Gardasil. Subsequently, the patient developed vaginal bleeding again. The patient was not due for menses. At the time of the report, the patient''s outcome was unknown. The physician felt that the vaginal bleeding was unrelated. Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 8/14/2007. Initial and follow-up information has been received from a certified medical assistant concerning a 21 year old female, who on 16-MAY-2007 at 11:20 was vaccinated in the left deltoid with a first dose of GARDASIL (Lot# 657736/0389U). On 16-MAY-2007 at 11:20 the patient developed vaginal bleeding for about a month. On 23-JUL-2007 at 11:15 the patient was vaccinated intramuscularly in the left deltoid with a 0.5mL second dose of GARDASIL (Lot# 658222/0927U). On 23-JUL-2007 at 11:15 the patient developed some spotting for 1 week that was not related to her cycle (also reported as vaginal bleeding). The patient was not due for menses. The physician felt that the vaginal bleeding was unrelated. Additional information is not expected.


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