VAERS ID: |
264585 (history) |
Form: |
Version 1.0 |
Age: |
22.0 |
Sex: |
Female |
Location: |
Kentucky |
Vaccinated: | 2006-10-10 |
Onset: | 2006-10-10 |
Days after vaccination: | 0 |
Submitted: |
2006-10-16 |
Days after onset: | 6 |
Entered: |
2006-10-16 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0868F / 1 |
LA / IM |
Administered by: Private Purchased by: Private Symptoms: Dizziness,
Hyperhidrosis,
Nausea,
Pallor,
Peripheral coldness SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
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: NONE Preexisting Conditions: NONE Allergies: Diagnostic Lab Data: CDC Split Type:
Write-up: Pt experienced paleness, sweating, cold hands, nausea, dizziness and lightheadedness. |