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This is VAERS ID 322817

Case Details

VAERS ID: 322817 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Foreign  
Vaccinated:2008-04-23
Onset:2008-04-23
   Days after vaccination:0
Submitted: 2008-08-20
   Days after onset:119
Entered: 2008-08-21
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1949U / 1 UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: WAES0808AUS00146

Write-up: Information was obtained on request by the Company from the agency via a Case Line Listing and a Public Case Detail Form concerning a 15 year old female who on 23-APR-2008 was vaccinated with the first dose of GARDASIL (Batch # K0532, Expiry date 12-JUN-2010, Lot # 659053/1949U). On 23-APR-2008, 6 hours after vaccination with GARDASIL, the patient experienced chest pain. It was described as thoracic pain that has failed to settle to date. At the time of reporting to the agency on 14-MAY-2008 the patient had not yet recovered from the chest pain. The agency considered that chest pain was possibly related to therapy with GARDASIL. The original reporting source was not provided. Chest pain was considered to be disabling by the reporting agency. Additional information is not expected.


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