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This is VAERS ID 411771

Case Details

VAERS ID: 411771 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Male  
Location: Illinois  
Vaccinated:2010-11-04
Onset:2010-11-04
   Days after vaccination:0
Submitted: 2010-11-06
   Days after onset:2
Entered: 2010-12-06
   Days after submission:30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0087Y / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Headache, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: None
Current Illness: Wart
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Had Liq-Nitrogen rx to wart - gave HPV #2 IM - told pt to wait 15 minutes before they could leave - Adult person with child came to inform us - he had headache & nausea - Pt checked vitals normal - asked to laid down - gave clear fluids po - emesis - discharged after 1 hr 10 minutes to home - continued with headache until 7pm resolved without problems (pain noted 10 on pain scale).


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