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This is VAERS ID 291286

Case Details

VAERS ID: 291286 (history)  
Form: Version 1.0  
Age: 14.0  
Sex: Female  
Location: Arizona  
Vaccinated:2007-07-11
Onset:2007-07-11
   Days after vaccination:0
Submitted: 2007-09-24
   Days after onset:75
Entered: 2007-09-25
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Laboratory test, Migraine, Nuclear magnetic resonance imaging, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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? Yes, 5 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC Split Type: WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


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