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This is VAERS ID 267429

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

Case Details

VAERS ID: 267429 (history)  
Form: Version .0  
Age: 22.0  
Sex: Female  
Location: Florida  
Vaccinated:2006-10-05
Onset:2006-10-05
   Days after vaccination:0
Submitted: 2006-11-14
   Days after onset:40
Entered: 2006-11-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Private       Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Hypoaesthesia, Injection site erythema, Injection site mass
SMQs:, Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Vestibular disorders (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? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Latex allergy; Drug hypersensitivity; Iodine allergy
Preexisting Conditions: Vaccination adverse reaction
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type:

Write-up: Information has been received from a physician and a 22 year old white female certified medical assistant with latex allergy, drug hypersensitivity to pertussis and iodine allergy and a history of unspecified adverse reaction after first dose of diphtheri"a toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid (at less than 1 year of age. On 05-OCT-2006, at 4:00 PM,. the patient was vaccinated, into the right arm, with a first dose of HPV (lot # 653978/0955F). On 05-OCT-2006, at 4:00 PM, the patie


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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=267429


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