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This is VAERS ID 264745

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 264745 (history)  
Form: Version .0  
Age: 16.0  
Sex: Female  
Location: Maine  
Vaccinated:2006-08-31
Onset:2006-09-06
   Days after vaccination:6
Submitted: 2006-10-13
   Days after onset:37
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Unintended pregnancy, Viral infection
SMQs:, Normal pregnancy conditions and outcomes (narrow)

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? No
Previous Vaccinations:
Other Medications: Zoloft
Current Illness: Breast lump, Flu symptoms
Preexisting Conditions: Pregnancy, breast lump, flu symptoms. depression.
Allergies:
Diagnostic Lab Data: Urine beta human 09/06/06 positive.
CDC Split Type:

Write-up: Information has been received through the pregnancy registry from a nurse practitioner concerning a 15 year old female with no known drug allergies, and with depression who on 8/31/06 at 3:00pm was vaccinated IM in the right deltoid with the first dose of"HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653937/0637F). Illnesses at the time of vaccination included flu symptoms and a breast lump. Concomitant therapy included sertraline HCL (Zoloft). Other vaccinations given on 9/6/06 included diphtheria toxoid + pe


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