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Found 78 cases where Location is Vermont and Vaccine is HPV2 or HPV4 or HPV9 or HPVX

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Table

   
Event CategoryCountPercent
Permanent Disability11.28%
Office Visit33.85%
Emergency Room3241.03%
Emergency Doctor/Room22.56%
Hospitalized33.85%
Recovered4861.54%
Life Threatening11.28%
Not Serious1417.95%
TOTAL† 104† 133.33%
† Because some cases have multiple vaccinations and symptoms, a single case can account for multiple entries in this table. This is the reason why the Total Count is greater than 78 (the number of cases found), and the Total Percentage is greater than 100.

Case Details (Sorted by Age)

VAERS ID: 319844 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2008-07-15
Entered: 2008-07-17
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0806USA02240

Write-up: Information has been received from a physician concerning a female, her nurse, who in May 2008, was vaccinated intramuscularly with her first dose of GARDASIL (lot# not provided). The nurse stated that the experience with the vaccine was horrible, extremely painful and her arm hurt for 3 days. Subsequently, the patient recovered 4 days after the first dose. The patient sought unspecified medical attention on an unspecified date. Additional information has been requested.


VAERS ID: 322207 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Vermont  
Vaccinated:2008-08-11
Onset:2008-08-12
   Days after vaccination:1
Submitted: 2008-08-14
   Days after onset:2
Entered: 2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1740U / 3 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Malaise, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after injection patient again felt unwell with body aches,decreased energy, and abdominal pain.


VAERS ID: 467592 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2012-08-24
Entered: 2012-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Alopecia
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1208USA005085

Write-up: This spontaneous report was received from a physician refers to a physician''s daughter''s friend of unknown age, who in an unknown date was vaccinated with a dose of GARDASIL (dose, route and lot number not reported). No other co-suspects were reported. No concomitant medications were reported. The physician reported that on an unknown date, the patient developed hair loss after receiving GARDASIL. At the time of the report, the patient''s outcome was unknown. It was unspecified if the patient sought medical attention. This is one of several reports from the same source. Additional information has been requested.


VAERS ID: 568556 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-02-09
Entered: 2015-02-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1502USA003179

Write-up: Information has been received from a registered nurse referring to an unspecified amount of patients of unknown age and gender. The nurse reported that an unspecified amount of doses of GARDASIL (lot#, dose and route not reported) that underwent a temperature excursion was administered to the unspecified amount of patients on an unknown dates. No adverse effect was reported. Additional information has been requested.


VAERS ID: 399469 (history)  
Form: Version 1.0  
Age: 2.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-10-22
Onset:2009-10-22
   Days after vaccination:0
Submitted: 2010-08-04
   Days after onset:286
Entered: 2010-09-08
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Wrong drug administered
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: WAES0910USA02810

Write-up: Information has been received from a physician concerning a 33 month old female patient who on 22-OCT-2009 was inadvertently vaccinated with a dose of GARDASIL instead of measles virus vaccine live (Enders-Edmonston) (+) mumps virus vaccine live (Jeryl Lynn) (+) rubella virus vaccine live (Wistar RA 27/3) (MSD). There was no product confusion but a human error. The patient sought unspecified medical attention. Additional information has been requested.


VAERS ID: 295600 (history)  
Form: Version 1.0  
Age: 9.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-10-25
Onset:2007-10-25
   Days after vaccination:0
Submitted: 2007-11-01
   Days after onset:7
Entered: 2007-11-05
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1333U / 2 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Erythema, Pain, Pruritus, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: instantly ached, same afternoon of vaccine increased swelling and redness. Redness and swelling persisted x 4 days. (+) itch.


VAERS ID: 311652 (history)  
Form: Version 1.0  
Age: 9.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-05-01
Onset:2008-05-03
   Days after vaccination:2
Submitted: 2008-05-05
   Days after onset:2
Entered: 2008-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1448U / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B019AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1768U / 2 LA / SC

Administered by: Other       Purchased by: Public
Symptoms: Erythema, Inappropriate schedule of drug administration, Local reaction, Pain in extremity, Skin warm
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~Varicella (Varivax)~2~6.00~In Sibling
Other Medications: Lexapro 5mg daily
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: c/o R arm hurt on 5/2/08 & then on 5/3/08 arm redness & warmth developed. 7 1/2" L x 6" W redness & warmth R upper arm. Able to lift arm overhead & strong hand squeezage. Dx: Local reaction to shot, allergic vrs. cellulitis. TC to mom 5/5/08 & she did begin Keflex 500mg TID x5 days due to increased redness below elbow. Taking as prescribed.


VAERS ID: 549261 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Male  
Location: Vermont  
Vaccinated:2014-10-10
Onset:2014-10-10
   Days after vaccination:0
Submitted: 2014-10-13
   Days after onset:3
Entered: 2014-10-21
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. CJ2105 / 2 NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K001631 / 2 LA / UN

Administered by: Private       Purchased by: Public
Symptoms: Fall, Head injury, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Accidents and injuries (narrow), Cardiomyopathy (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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Around 1520 patient was standing with brother against the wall waiting for mom to finish in bathroom. Both gave staff a high 5 and about 5 seconds later patient fell and hit his head on opposite wall. Patient was carried back to room 3 and Dr rushed in to exam him. Syncopal event shortly after receiving vaccines.


VAERS ID: 640300 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-05-25
Onset:2016-05-25
   Days after vaccination:0
Submitted: 2016-05-25
   Days after onset:0
Entered: 2016-05-27
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L043213 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5228BA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS 9Y57K / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Face injury, Fall, Immediate post-injection reaction, Seizure, Tooth fracture
SMQs:, Systemic lupus erythematosus (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Generalised convulsive seizures following immunisation (narrow), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Hx of 34 week prematurity; mild pulmonary stenosis
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt was given MENACTRA and HPV in (R) arm. Seconds later was given Tdap in (L) arm and immediately fell forward off table and hit face on floor. Seizure for less than 20 seconds. Broke off tooth in process. Pt with hx anxiety with vaccines especially.


VAERS ID: 323917 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-08-22
Onset:2008-08-28
   Days after vaccination:6
Submitted: 2008-09-02
   Days after onset:5
Entered: 2008-09-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0381X / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2686AA / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Pharyngolaryngeal pain, Rash
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ~DTaP (no brand name)~5~4.00~In Patient
Other Medications:
Current Illness: None
Preexisting Conditions: ?Tetanus toxoid
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Please see hospital notes - skin rash. Patient has developed a rash over the last 2 hours on her arms and left knees. She is now complaining of throat pain. She got her first GARDASIL shot and her meningitis vaccine about 7 days ago and her mom says when patient was five she had a reaction to a tetanus shot 6 days after she got the vaccine. Mom is concerned.


VAERS ID: 402008 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Vermont  
Vaccinated:2010-09-30
Onset:2010-09-30
   Days after vaccination:0
Submitted: 2010-09-30
   Days after onset:0
Entered: 2010-10-06
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1333Y / 3 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3475AA / UNK LA / UN

Administered by: Public       Purchased by: Other
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncopy after TDap and HPV vaccines. Pt seated, evaluated by FNP. Pt quickly regained consciousness. Left clinic with mom 15 minutes later asymptomatic.


VAERS ID: 422765 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Vermont  
Vaccinated:2011-04-26
Onset:2011-05-02
   Days after vaccination:6
Submitted: 2011-05-12
   Days after onset:10
Entered: 2011-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1167Z / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3671AA / 1 RA / UN
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC523048AC / 1 LA / UN

Administered by: Private       Purchased by: Other
Symptoms: Rash generalised
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: 5/2/11 Phone call from mom stating "bug bite" looking rash all over body. Not ill. No fever. Probably, per mom, related to old sunscreen.


VAERS ID: 571471 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Male  
Location: Vermont  
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted: 2015-03-12
Entered: 2015-03-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / UNK RA / IM

Administered by: Public       Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


VAERS ID: 645269 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-06-29
Onset:2016-06-30
   Days after vaccination:1
Submitted: 2016-07-01
   Days after onset:1
Entered: 2016-07-25
   Days after submission:24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L019297 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5186AA / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site induration, Injection site reaction, Injection site warmth, Pallor
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypotonic-hyporesponsive episode (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: multivitamin
Current Illness:
Preexisting Conditions: Allergy to amoxicillin
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 9 cm indurated warm local blanching area surrounding vaccine.


VAERS ID: 443733 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Vermont  
Vaccinated:2011-11-15
Onset:2011-11-15
   Days after vaccination:0
Submitted: 2011-11-16
   Days after onset:1
Entered: 2011-11-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UT4197B / 7+ LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0692AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4008AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Chest discomfort, Dyspnoea, Rash erythematous, Rash pruritic, Sensory loss
SMQs:, Anaphylactic reaction (narrow), Peripheral neuropathy (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: FLOVENT; PRO-AIR; SINGULAIR
Current Illness: Physical
Preexisting Conditions: Asthma; Seasonal allergies
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Had below imms on 11/15/11. That eve - red, itchy rash bil hands. Then chest tight. Took to ER - given BENADRYL. They thought possibly viral. Slept well. Next AM SOB, chest tight, no feeling (R) hand. Rash continues. On BENADRYL and her albuterol (has asthma). Site of injection WNL, no erythema, no edema.


VAERS ID: 589825 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Male  
Location: Vermont  
Vaccinated:2015-08-06
Onset:2015-08-06
   Days after vaccination:0
Submitted: 2015-08-10
   Days after onset:4
Entered: 2015-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 3RB2G / 2 LA / UN
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. K026247 / 3 RA / UN

Administered by: Private       Purchased by: Public
Symptoms: Chills, Decreased appetite, Fatigue, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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: Vitamins
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Pt received Hep A and HPV vaccine at approximately 11 AM on 8-6-15-mom called at 4:30 the same day with concerns of chills-decreased appetite and fatigue-pt then had severe vomiting for several hrs and went to ER.


VAERS ID: 634180 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Vermont  
Vaccinated:2016-05-03
Onset:2016-05-04
   Days after vaccination:1
Submitted: 2016-05-04
   Days after onset:0
Entered: 2016-05-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L043213 / 3 LA / UN

Administered by: Other       Purchased by: Other
Symptoms: Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: TC from mom 5/4/16. Received #3 HPV 5/3/16 pm. Developed a fever only 101.6-$g102.5. No other symptoms.


VAERS ID: 715558 (history)  
Form: Version 2.0  
Age: 12.0  
Gender: Female  
Location: Vermont  
Vaccinated:2014-08-27
Onset:2014-09-15
   Days after vaccination:19
Submitted: 0000-00-00
Entered: 2017-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J015378 / 1 LA / SYR

Administered by: Private       Purchased by: 0
Symptoms: Arthralgia, Babesiosis, Chronic fatigue syndrome, Condition aggravated, Headache, Lyme disease, Postural orthostatic tachycardia syndrome
SMQs:, Arthritis (broad), Dehydration (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Chronic fatigue syndrome; POTS; Babesiosis Lyme disease; Chronic headache
Allergies: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chronic headache, POTS, Babesiosis Lyme disease, Chronic fatigue syndrome, Joint pain.


VAERS ID: 715563 (history)  
Form: Version 2.0  
Age: 12.0  
Gender: Female  
Location: Vermont  
Vaccinated:2012-08-20
Onset:2012-08-28
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2017-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0459AE / 1 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3927AA / 1 LA / UN

Administered by: Private       Purchased by: 0
Symptoms: Pyrexia, Rash generalised
SMQs:, Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: Chronic knee pain; Anxiety; Chronic abdominal pain; Gastritis
Allergies: No
Diagnostic Lab Data:
CDC Split Type:

Write-up: W/one day patient had a rash all over her body. Fever.


VAERS ID: 286442 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-07-31
Onset:2007-08-01
   Days after vaccination:1
Submitted: 2007-08-01
   Days after onset:0
Entered: 2007-08-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Erythema, Eye swelling, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Patient awoke day after receiving HPV with eyes swollen shut, red itchy periorbital rash. Seen early afternoon approximately 24 hrs after injection. Eyes open, rash represent with residual swelling. Rx: Applications of cold, benedryl or claritin, motrin for inflammation. Photo taken of pt.


VAERS ID: 289057 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-08-22
Onset:0000-00-00
Submitted: 2007-08-24
Entered: 2007-08-27
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0930U / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0535U / 2 RA / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Cold compress therapy, Injection site erythema, Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Redness, warmth, swelling and tenderness at injection site. Advised cold compresses, ibuprofen, Benadryl and monitor.


VAERS ID: 321786 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-07-24
Onset:2008-07-27
   Days after vaccination:3
Submitted: 2008-08-11
   Days after onset:15
Entered: 2008-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1968U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2633AA / 1 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Blood creatine phosphokinase, Borrelia burgdorferi serology negative, Full blood count, Gait disturbance, Headache, Myalgia, Pain, Parvovirus B19 serology positive, Pyrexia, Red blood cell sedimentation rate increased
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: H/O peanut/nut allergy
Allergies:
Diagnostic Lab Data: CK; Mono; BH: CBC; Lyme titer NL; ESR increased, 30; Parvo B19, c/w post infection
CDC Split Type:

Write-up: Fever 101-103 associated with headache & body aches. Intense muscle aches lower extrem $g upper extrem to the point of difficulty walking, getting out of chair, etc. Duration 5-6d. Rx ibuprofen 600mg q 6 hr.


VAERS ID: 322205 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-02-04
Onset:2008-02-05
   Days after vaccination:1
Submitted: 2008-08-14
   Days after onset:190
Entered: 2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Malaise, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after gardisil feels unwell with abdominal pain, ackey, sore decresed energy lasting approx 1 to 2 days


VAERS ID: 322206 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-04-07
Onset:2008-04-08
   Days after vaccination:1
Submitted: 2008-08-14
   Days after onset:128
Entered: 2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1448U / 2 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Asthenia, Influenza like illness, Malaise, Pain
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: 24 hours after 2nd HPV injection patient became ill with flu like symtoms, body aches, abdomial pain, decreased energy, generlly feeling unwell.


VAERS ID: 341638 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-09-10
Onset:2008-10-10
   Days after vaccination:30
Submitted: 2009-03-12
   Days after onset:153
Entered: 2009-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0843X / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2661AA / 1 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Type 1 diabetes mellitus, Vision blurred
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Anticholinergic syndrome (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypoglycaemia (broad)

Life Threatening? Yes
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 noted
Preexisting Conditions: None. PMH: acne.
Allergies:
Diagnostic Lab Data: Labs: Fasting glucose 247. UA (+) for glucose and mod ketones. Hgb A1C 11.1%.
CDC Split Type:

Write-up: Mom is requesting VAERS done...one month after receiving MENACTRA & 1st GARDASIL on 9/10/08, Pt had blurred vision. 3 months later diagnosed with Type 1 Diabetes. 3/16/09 MR received from PCP including endocrine consult. Seen for !# yr WCC 9/10/08. Assessment: healthy. PE WNL. Vax given. Seen by ophth for intermittant blurry vision with visual acuity OK. Seen 1/29/09 with c/o onset excessive thirst, recent weight loss and increased UO. Reports feeling tired. Dx: New onset Diabetes Type I after labs. Referred to endocrine. Dx: IDDM.


VAERS ID: 372082 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-11-24
Onset:2009-11-24
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2009-12-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0819Y / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3062AA / 1 RA / UN
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER AC52B049B / 1 LA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Electrocardiogram QT prolonged, Full blood count normal, Loss of consciousness, Metabolic function test, Syncope
SMQs:, Torsade de pointes/QT prolongation (narrow), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Conduction defects (narrow), Torsade de pointes, shock-associated conditions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Prolonged QT on EKG done @ ER all other labs WNL (CBC, BMP)
CDC Split Type:

Write-up: Syncope 15 min after receiving vaccine with LOC.


VAERS ID: 460351 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Male  
Location: Vermont  
Vaccinated:2012-07-26
Onset:2012-07-26
   Days after vaccination:0
Submitted: 2012-07-26
   Days after onset:0
Entered: 2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB492BA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1696AA / 2 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1062AA / 2 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: No additional tests, required
CDC Split Type:

Write-up: Patient came in for 2nd Hepatitis A, 2nd HPV & 2nd Varicella, Hep A, Varicella given left deltoid, HPV given (R) deltoid. Within 15 minutes of vaccination; patient was having systemic hive reaction. Pt given 25 mg 2 ml BENADRYL when pt discharged was much improved.


VAERS ID: 467444 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2012-04-12
Onset:0000-00-00
Submitted: 2012-08-24
Entered: 2012-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Alopecia
SMQs:

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: No other medications
Current Illness: Unknown
Preexisting Conditions: Convulsion, one seizure as a child
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES1208USA004035

Write-up: This spontaneous report was received from a physician refers to a 14 years old female patient with a history of one seizure as a child, who on 07-OCT-2011, 08-DEC-2011 and on 12-APR-2012, was vaccinated with the first, second and third dose of GARDASIL respectively (doses, routes and lot numbers not reported). No other co-suspects were reported. No concomitant medications were reported. The physician reported that about a month ago, in approximately July 2012, the patient developed unexplained alopecia after completion of the GARDASIL series. No treatment was given for the experience. No lab diagnostics studies were performed. At the time of the report, the patient had not recovered. The relatedness for the patient had developed unexplained alopecia after completion of the GARDASIL series was unknown for GARDASIL. This is one of several reports from the same source. Additional information has been requested.


VAERS ID: 570681 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Male  
Location: Vermont  
Vaccinated:2015-02-24
Onset:2015-02-24
   Days after vaccination:0
Submitted: 2015-03-05
   Days after onset:9
Entered: 2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 3 UN / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain upper, Blood glucose, Dizziness, Nausea, Nervousness, Throat irritation
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Blood glucose and O2 sat checked and VS
CDC Split Type:

Write-up: Patietn felt shaky, throat felt "funny"- stomach pain-nauseated dizzy.


VAERS ID: 573780 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Male  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2015-04-09
Entered: 2015-04-14
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS X9LB7 / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Chest X-ray normal, Electrocardiogram normal, Heart rate irregular, Palpitations
SMQs:, Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Cardiac arrhythmia terms, nonspecific (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Normal EKG and chest x-ray in ED.
CDC Split Type:

Write-up: Heart pounding and irregular rate. No CP/SOB/N.


VAERS ID: 580298 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2015-05-11
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2015-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4680AA / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Blister, Erythema, Injection site erythema, Injection site swelling, Pruritus, Skin tightness
SMQs:, Severe cutaneous adverse reactions (broad), Anaphylactic reaction (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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:
Current Illness: None
Preexisting Conditions: Depression; Asthma
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Began 2 days after injection with redness, swelling, tightness of the right arm and grouped vesicles on erythematous base covering extremities and think -very pruritic with dermatographism.


VAERS ID: 671888 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Vermont  
Vaccinated:2016-12-06
Onset:2016-12-07
   Days after vaccination:1
Submitted: 2016-12-07
   Days after onset:0
Entered: 2016-12-13
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UI684AB / 7+ LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M016193 / 3 RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Blindness transient, Dizziness, Head injury, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Embolic and thrombotic events, arterial (narrow), Accidents and injuries (narrow), Glaucoma (broad), Optic nerve disorders (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No illness
Preexisting Conditions: Entoptic phenomenon; no other dxs; no allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Received vaccine 12/6/16 no adverse symptoms or events until 12/7/16 at 0515 while pt in shower. Pt began to feel lightheaded, dizzy, (+) blurred vision. About 30 sec couldn''t see. No LOC. Hit head (right side). Frontal H/A rates 2/10. Negative for N/V.


VAERS ID: 321792 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-08-05
Onset:2008-08-05
   Days after vaccination:0
Submitted: 2008-08-05
   Days after onset:0
Entered: 2008-08-11
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1968U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2384BA / 1 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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: Syncope ~3 min - cold cloths to forehead, juice.


VAERS ID: 322296 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-08-13
Onset:2008-08-14
   Days after vaccination:1
Submitted: 2008-08-15
   Days after onset:1
Entered: 2008-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1740U / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B027AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0334X / 2 RA / SC

Administered by: Private       Purchased by: Public
Symptoms: Injection site pain, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Upper Right arm slightly swollen, hot to touch, pain with shoulder abduction. At site of varicella injection.


VAERS ID: 336731 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-12-23
Onset:2008-12-23
   Days after vaccination:0
Submitted: 2009-01-07
   Days after onset:15
Entered: 2009-01-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Syncope within minutes of administration of vaccines.


VAERS ID: 391077 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Vermont  
Vaccinated:2010-06-15
Onset:2010-06-15
   Days after vaccination:0
Submitted: 2010-06-15
   Days after onset:0
Entered: 2010-06-21
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1333Y / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1411X / 2 RA / SC

Administered by: Private       Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: T : 98.8; HR, 76; FSBS, 93; BP, 128/78; RR, 16
CDC Split Type:

Write-up: GARDASIL & VARICELLA vaccine given. Pt alert, appropriate. Escorted to hall. Pt had syncopal episode, attended & examined by PA. VSS.


VAERS ID: 292270 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-07-17
Onset:2007-07-17
   Days after vaccination:0
Submitted: 2007-10-07
   Days after onset:82
Entered: 2007-10-05
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 3 RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Injection site discharge, Injection site erythema, Injection site haemorrhage, Injection site induration, Injection site scab
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Same day as administered, injection site bled, oozed clear fluid and eventually scabbed over. Site also became red, with a hard lump, this lasted for 3 weeks. Pt applied ice and used ibuprofen as treatment.


VAERS ID: 298953 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-11-26
Onset:2007-11-26
   Days after vaccination:0
Submitted: 2007-11-28
   Days after onset:2
Entered: 2007-12-06
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2386BA / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Drug hypersensitivity, Erythema, Musculoskeletal stiffness, Pruritus, Rash, Skin warm, Swelling
SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Pharyngitis
Preexisting Conditions: Bactrim-Rash
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: stiff neck within 12 hr-redness-swelling-hot itchy x 24 hr


VAERS ID: 320916 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-07-25
Onset:2008-07-26
   Days after vaccination:1
Submitted: 2008-07-28
   Days after onset:2
Entered: 2008-07-31
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1968U / 2 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Oedema peripheral, Rash
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Rash on various parts of body right thumb swollen.


VAERS ID: 356861 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-08-19
Onset:2009-08-19
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2009-09-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0672Y / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope several seconds after HPV shot, recovered after several minutes (out X approximately 30 sec) took approximately 10 min to feel better.


VAERS ID: 454508 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2012-04-26
Entered: 2012-04-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Amnesia, Conversion disorder, Convulsion, Headache, Injury, Loss of consciousness, Musculoskeletal chest pain, Nuclear magnetic resonance imaging brain abnormal, Paraesthesia, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dementia (broad), Convulsions (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Accidents and injuries (narrow), Hostility/aggression (broad), Glaucoma (broad), Lens disorders (broad), Retinal disorders (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Magnetic resonance, Brain: Conversion
CDC Split Type: WAES1204USA02620

Write-up: Information has been received from a consumer concerning currently 15 year old female patient with no pertinent medical history and no drug reactions/allergies who on an unspecified date, was vaccinated with the second dose of GARDASIL (lot # and route not reported) 0.5 ml. There was no concomitant medication. Consumer reported that on an unspecified date, minutes after getting her second GARDASIL dose, the patient had a seizure and was taken to the emergency room (ER) of an unspecified hospital. They did a magnetic resonance imaging (MRI) of her brain and the diagnosis was a conversion, which was a misfiring of the electrons in her brain due to traumatic bodily injury. Since this happened, she had had headaches, passed out all the time. she had tingling in her hands and feet, blurry vision, pain in her rib area, and a loss of memory of the last three years. She went to an unspecified neurologist, who could not pin it to the vaccine. She had missed 55 days of school since the event started. The patient''s mother said that physician dismissed the idea that it was due to the vaccine, so she switched to an unspecified doctor in the same practice. The consumer had been to the emergency room (ER) multiple times. It was reported that the events occurred after reintroduction. It was also reported that these events were a significant disability. It was not know if the days of school the consumer missed were consecutive and if the patient was ever admitted to the hospital. At the time of the report, the patient''s outcome was unknown. Therapy with GARDASIL was discontinued after the events happened. Additional information has been requested.


VAERS ID: 622962 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-02-10
Onset:2016-02-12
   Days after vaccination:2
Submitted: 2016-02-17
   Days after onset:5
Entered: 2016-02-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U5304AB / 7+ LA / IM
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L019297 / 3 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Aggression, Headache, Vision blurred
SMQs:, Anticholinergic syndrome (broad), Dementia (broad), Hostility/aggression (narrow), Glaucoma (broad), Lens disorders (broad), Retinal disorders (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: Concerta 36mg; Ventolin HFA
Current Illness:
Preexisting Conditions: ADHD; Cough Variant Asthma; Migraine
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Blurry vision, headache, combative.


VAERS ID: 289045 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-08-27
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2007-08-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09284 / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Loss of consciousness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Orthotricyclen
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: First dose of Gardasil was administered. Patient fainted, losing consciousness for 10 seconds with full recovery. Lot # 09284, left arm IM


VAERS ID: 304109 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-11-14
Onset:2007-11-14
   Days after vaccination:0
Submitted: 2008-01-25
   Days after onset:72
Entered: 2008-02-01
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0929U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2182AA / 1 RA / IM

Administered by: Private       Purchased by: Public
Symptoms: Bradycardia, Electrocardiogram, Laboratory test, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Yaz
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: Labs EKG - Seen by cardiologist ER LABS: CBC, chemistry, cardiac enzymes, UA all WNL. Hospital LABS: EKG revealed bracycardia. Echocardiogrm WNL. Stress test WNL.
CDC Split Type:

Write-up: Immediately after shots - became Faint with pulse 50; Next Am had syncopal episode -$g ER -$g hosp Adm. with significant bradycardia -$g cardiac work-up; now on Atenolol. 2/1/08 Reviewed ER medical records of 11/15/07 which reveal patient experienced feeling lightheaded, warmth & nauseated. Felt faint, lost consciousness & collapsed for approx 1 min witnessed by parent. Recovered at the scene. In ER placed on O2. Had additional episodes of syncope w/HR 30''s while laying on gurney in ER. Noted to have eye twitching, pallor & eyes rolling back in head, flaccid. Awoke immediately but was very tired. Transferred to higher level of care. FINAL ER Dx: syncope of unknown cause. 2/8/08 Reviewed hospital medical records which reveal patient admitted to PICU 11/15-11/16/2007. Cardio consult done. Syncopal episodes felt to be neurocardiogenic w/significant cardioinhibitory component, resulting in secondary bardycardia/asystole & syncope. Tx w/meds & hydration & d/c to home w/cardio f/u. FINAL DX: syncope, probably neurally-mediated syncope; periods of marked bradycardia.


VAERS ID: 344691 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-04-23
Onset:2009-04-23
   Days after vaccination:0
Submitted: 2009-04-23
   Days after onset:0
Entered: 2009-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1740U / 2 RA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After leaving office Pt had a delayed fainting spell - Returned to office - No injury.


VAERS ID: 383270 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2010-02-09
Onset:2010-02-11
   Days after vaccination:2
Submitted: 2010-03-22
   Days after onset:38
Entered: 2010-03-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1099Y / 3 LA / UN

Administered by: Unknown       Purchased by: Private
Symptoms: Computerised tomogram normal, Electroencephalogram normal, Endotracheal intubation, Epilepsy, Grand mal convulsion, Laboratory test normal, Movement disorder, Nuclear magnetic resonance imaging normal, Postictal state, Sedation, Simple partial seizures, Speech disorder
SMQs:, Angioedema (broad), Systemic lupus erythematosus (broad), Anticholinergic syndrome (broad), Dementia (broad), Convulsions (narrow), Akathisia (broad), Dyskinesia (broad), Dystonia (broad), Parkinson-like events (broad), Psychosis and psychotic disorders (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Generalised convulsive seizures following immunisation (narrow), Respiratory failure (broad), Hypoglycaemia (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? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: mild cold symptoms
Preexisting Conditions: allery to Keflex- reaction is hives; no other mediccal conditions
Allergies:
Diagnostic Lab Data: Epilepsy- no cause determined; lingering language and motor difficulties. MRI, CT, EEG and all labs were good.
CDC Split Type:

Write-up: 30-45 minute simple partial seizures followed by grand mal at about 7:00 pm. Very challenging post-ictal state requiring sedation and intubation, and 2 day hospital stay. Second seizure on 2/27/2010 followed same pattern. following


VAERS ID: 393383 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2010-07-22
Onset:2010-07-22
   Days after vaccination:0
Submitted: 2010-07-22
   Days after onset:0
Entered: 2010-07-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1333Y / 2 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (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: After apx. 5 min after receiving 2nd HPV vaccine pt passed out. Pt rested lying down - cool compress to head. BP immed after passing out 98/54 BP 15 min after resting 106/64.


VAERS ID: 447037 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2011-10-24
Onset:2011-10-24
   Days after vaccination:0
Submitted: 2012-01-02
   Days after onset:70
Entered: 2012-01-09
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN3: INFLUENZA (SEASONAL) (FLUMIST) / MEDIMMUNE VACCINES, INC. 501105P / 2 NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0692AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Adverse reaction, Hypoaesthesia, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Paresthesias - numbness, tingling involving both upper and lower extremities - Sx come and go but started on day of vaccine. Then more sx 2 wks later then again 2 wks later. Episodes last upwards of 1 hr - no known HA at time of attacks.


VAERS ID: 457428 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Male  
Location: Vermont  
Vaccinated:2012-06-07
Onset:2012-06-07
   Days after vaccination:0
Submitted: 2012-06-08
   Days after onset:1
Entered: 2012-06-14
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1495AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Dizziness, Nausea
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: C/O dizzy, nausea. VS remained stable. P between 76-80, BP 132/76 to 148/72. After D/C from clinic, went to ER. Given BENADRYL, Prednisone, PEPCID.


VAERS ID: 570682 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Unknown  
Location: Vermont  
Vaccinated:2015-03-04
Onset:2015-03-04
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC Split Type:

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


VAERS ID: 712690 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Vermont  
Vaccinated:2017-08-25
Onset:2017-08-25
   Days after vaccination:0
Submitted: 2017-09-11
   Days after onset:17
Entered: 2017-09-13
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M040412 / 3 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Fatigue, Headache, Loss of personal independence in daily activities, Muscle spasms, Pain, Pain in extremity, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Dementia (broad), Dystonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Mom called 8/26 AM the day after patient received her 3rd HPV #9. Reported fever of 101 at 9 pm she also had leg aches, body aches and muscle cramps. She had a bad headache and extreme exhaustion. 8/28 - headache and fever better. Patient is a runner and unable to run more than 10 mins over next 3-4 days. Pain in arms. Experiencing pain in arm and legs, unable to run, extreme fatigue. Later pt reported that she felt like she was getting a cold for 24 hours after first two shots. She did not report this until after 3rd shot.


VAERS ID: 271114 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2006-11-30
Onset:2006-11-30
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:47
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA02571

Write-up: Information has been received from a nurse practitioner concerning a 17 year old female with no medical history or allergies, who on 30-Nov-2006 was vaccinated IM with a 0.5 ml dose of Gardasil vaccine (yeast). Concomitant therapy included an unspecified hormonal contraceptives (unspecified). On 30-Nov-2006, the patient experienced severe injection site pain. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


VAERS ID: 288150 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-08-15
Onset:2007-08-15
   Days after vaccination:0
Submitted: 2007-08-15
   Days after onset:0
Entered: 2007-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0680U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2234AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Dizziness, Immediate post-injection reaction, Musculoskeletal stiffness, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Dystonia (broad), Parkinson-like events (broad), Noninfectious encephalitis (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Arthritis (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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: I gave HPV first in LA and patient was standing and appeared fine. I then gave the Menactra vaccine in the RA and patient immediately fainted and body stiffened for less than one minute. She then quickly reoriented and stood up and she was fine. Had two dizzy spells while sitting down, but they resolved w/ her head b/w legs. Monitored pt x2: 1st laying then sitting, then standing.


VAERS ID: 290148 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-08-27
Onset:2007-08-28
   Days after vaccination:1
Submitted: 2007-09-07
   Days after onset:10
Entered: 2007-09-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Anorexia, Chills, Fatigue, Pyrexia, Rash erythematous, Swelling face
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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 began to feel fatigue and anorexic the day after administration. This became progressively worse and then developed chills and rash on day 4. On day 5 awoke with swollen face, temp 101.3 in office and erythematous rash on face and slight on left upper arm and upper chest. Was seen in the office at that point and recommended to initiate Benadryl 50mg every 6 hrs for 48 hrs. Her fever was gone the next day and the swelling and rash subsided within 2-3 days.


VAERS ID: 294458 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-10-19
Onset:2007-10-19
   Days after vaccination:0
Submitted: 2007-10-25
   Days after onset:6
Entered: 2007-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / 3 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Rash generalised, Rash pruritic
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Prozac; Denizen
Current Illness: None noted
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: 10/19/07 Received HPV #3, itchy rash started several hours after HPV #3 at injection site. Spread all over body. Took Benadryl. Rash gone 3-4 hrs later.


VAERS ID: 309052 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Unknown  
Location: Vermont  
Vaccinated:2008-04-02
Onset:0000-00-00
Submitted: 0000-00-00
Entered: 2008-04-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB216AA / UNK LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1740U / UNK RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Convulsion, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Systemic lupus erythematosus (broad), Arrhythmia related investigations, signs and symptoms (broad), Convulsions (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (narrow), 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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: After HPV and Hep A were administered patient fainted and had a brief seizure lasting approx. 30 seconds. Patient recovered and left with mom. HPV isn''t listed under vaccines: Merck, lot # 1740U, right arm, IM.


VAERS ID: 319516 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-07-16
Onset:2008-07-16
   Days after vaccination:0
Submitted: 2008-07-17
   Days after onset:1
Entered: 2008-07-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 2 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1465U / 2 LA / SC

Administered by: Private       Purchased by: Public
Symptoms: Hypoaesthesia, Nausea, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Guillain-Barre syndrome (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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Numbness in face, hands, & abdomen, nausea, vomiting x4.


VAERS ID: 450173 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Male  
Location: Vermont  
Vaccinated:2011-11-22
Onset:2012-01-02
   Days after vaccination:41
Submitted: 2012-02-15
   Days after onset:44
Entered: 2012-02-23
   Days after submission:8
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0690AA / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3837AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain, Endoscopy gastrointestinal
SMQs:, Acute pancreatitis (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (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:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Completion GI eval including endoscopy
CDC Split Type:

Write-up: Chronic abd pain.


VAERS ID: 526925 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Vermont  
Vaccinated:2014-02-21
Onset:2014-03-16
   Days after vaccination:23
Submitted: 2014-03-27
   Days after onset:11
Entered: 2014-03-28
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J008423 / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Anti-ganglioside antibody negative, Areflexia, Diplopia, Electromyogram abnormal, Facial paresis, Immunoglobulin therapy, Laboratory test, Lumbar puncture normal, Metabolic function test, Miller Fisher syndrome, Muscular weakness, Paraesthesia, Sensory disturbance, VIIth nerve paralysis
SMQs:, Rhabdomyolysis/myopathy (broad), Peripheral neuropathy (narrow), Guillain-Barre syndrome (narrow), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hearing impairment (broad), Ocular motility disorders (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: EMG c/w GBS; metabolic panel; Neg LP; neg ganglioside panel; some studies still pending
CDC Split Type:

Write-up: Teen presented 3/18 with facial weakness, diplopia, and tingly progressed with a descending weakness areflexia felt consistent with Miller Fisher syndrome - a Guillain Barre variant. Received IVIG x 5 days with improvement in facial palsies, but persistent weakness, sensory changes.


VAERS ID: 626442 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Male  
Location: Vermont  
Vaccinated:2016-03-02
Onset:2016-03-03
   Days after vaccination:1
Submitted: 2016-03-04
   Days after onset:1
Entered: 2016-03-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 294X9 / 1 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L019297 / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5058AC / UNK - / IM

Administered by: Private       Purchased by: Public
Symptoms: Back pain, Decreased appetite, Diarrhoea, Dizziness, Fatigue, Headache, Immediate post-injection reaction, Rash
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Hypersensitivity (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: To ER on 3/4/16
CDC Split Type:

Write-up: Pt appeared light headed immediately after immunizations, which care was rendered, mom in attendance on 3/3/16. Next day mom called to report diarrhea, rash on bilat arms, fatigued, headache, poor appetite and not taking in fluids. Also with lower back pain. Sent to ER 3/4/16.


VAERS ID: 278394 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-05-08
Onset:2007-05-08
   Days after vaccination:0
Submitted: 2007-05-10
   Days after onset:2
Entered: 2007-05-11
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B012AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain upper, Asthenia, Body temperature increased, Chills, Ear pain, Erythema, Malaise, Nausea, Neck pain, Pain, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: PPD acne facial Rx products Clindamycin gel + Diff gel
Current Illness: none
Preexisting Conditions: Allergies-Ceclor, minocycline, benzyl peroxide
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5/8/07 Sleeping and woke up with chills and c/o neck pain and aches-$g Motrin 600 mg. 5/9/07 c/o nausea, stomachache, earaches T 102.4 deg at 3:00 pm Ears ok one red canal only per school nurse-ES Tylenol given and slept 3-4-07 pale and c/o weak and not feeling well. School nurse checked -$g adeq strength/BP 102/60 P72 no numbness/tingling All s/s resolved in pm.


VAERS ID: 539728 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Vermont  
Vaccinated:2014-08-04
Onset:2014-08-05
   Days after vaccination:1
Submitted: 2014-08-11
   Days after onset:6
Entered: 2014-08-12
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J009243 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4678AA / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Arthralgia, Asthenia, Blood iron, Body temperature increased, Condition aggravated, Epistaxis, Fatigue, Full blood count, Headache, Pain, Serum ferritin, Vitamin B12
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Retroperitoneal fibrosis (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: Chronic headaches
Preexisting Conditions: Epistaxis; Headaches
Allergies:
Diagnostic Lab Data: CBC, Vitamin B12, Ferritin, Iron - Drawn due to long term history of headache on 8/7/14
CDC Split Type:

Write-up: Starting on 8/5 pt experienced joint pain, weakness, aching, fatigue, abdominal pain, headaches. These symptoms lasted until 8/5-8/11. Had one more severe episode of epistaxis which she has weekly. Also had 6 days (six) of temp of 100. Concern of extreme fatigue this week.


VAERS ID: 707601 (history)  
Form: Version 2.0  
Age: 18.0  
Gender: Male  
Location: Vermont  
Vaccinated:2017-08-10
Onset:2017-08-10
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2017-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M042853 / 3 RA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 15C601 / 2 RA / IM

Administered by: Private       Purchased by: 0
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Patient shared after the event that he had a similar episode in the past but didn''t know related to what vaccine or even when th
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Allergies: none
Diagnostic Lab Data:
CDC Split Type:

Write-up: Syncope immediately after vaccination.


VAERS ID: 305734 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-02-20
Onset:2008-02-22
   Days after vaccination:2
Submitted: 2008-02-26
   Days after onset:4
Entered: 2008-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1486U / 3 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Auricular swelling, Basophil count normal, Dermatitis allergic, Dyspnoea, Erythema, Haematocrit normal, Haemoglobin normal, Lymphadenopathy, Lymphocyte count decreased, Monocyte count normal, Mononucleosis heterophile test negative, Neutrophil count increased, Pharyngeal oedema, Pharyngolaryngeal pain, Platelet count normal, Pruritus, Rash pruritic, Throat irritation, White blood cell count
SMQs:, Anaphylactic reaction (narrow), Angioedema (narrow), Haematopoietic leukopenia (narrow), Systemic lupus erythematosus (broad), Oropharyngeal allergic conditions (narrow), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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: oral contraceptive
Current Illness: none
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Monospot negative; WBC 10.8; diff: 79Neu, 15Lym, 2 bands, 3 monos, 1 basos; Hgb 13.1; Hct 39.4; Plt 413;
CDC Split Type:

Write-up: Pt developed sore throat on 2/22, developed itching, burning, swelling in throat and ears on 2/25. Tender cervical LAD, felt short of breath. Red, pruritic rash across abdomen and upper thighs with some involvement of arms, appears allergic in nature. No source of infection on examination. Patient d/c''ed from clinic with fexofenadine.


VAERS ID: 349840 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-06-17
Onset:2009-06-18
   Days after vaccination:1
Submitted: 2009-06-23
   Days after onset:5
Entered: 2009-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0653X / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2911AA / 1 RA / IM

Administered by: Public       Purchased by: Public
Symptoms: Chest discomfort, Feeling cold, Injection site pain, Palpitations
SMQs:, Anaphylactic reaction (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: none~ ()~NULL~~In Patient
Other Medications:
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: pt''s mother called pt complained of soreness at the site and feeling cold. The next day she c/o her heart racing and feeling some discomfort in her chest.


VAERS ID: 459795 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Male  
Location: Vermont  
Vaccinated:2012-06-09
Onset:2012-06-09
   Days after vaccination:0
Submitted: 2012-07-13
   Days after onset:34
Entered: 2012-07-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0131AE / UNK UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3906AA / 2 UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Immediate post-injection reaction, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 06/09/2012, Heart rate, 60; 06/09/2012, Diagnostic, 100/60; 06/09/2012, Diagnostic, 112/73
CDC Split Type: WAES1206USA04036

Write-up: Information has been received from a licensed practice nurse concerning a 19 year old male patient with no pre-existing allergies and no medical conditions who on 09-JUN-2012 was vaccinated into left arm with a dose of GARDASIL (lot # 672834/0131AE). Concomitant therapy included a second dose of MENACTRA (lot # U3906AA, into left arm) given on the same day. No other concomitant therapy. On 09-JUN-2012 the patient fainted within 1 minute after administration with vaccine. Head and feet were elevated. Ice pack was applied. Ammonia inhalant was used to bring patient aware. Blood pressure was 100/60 and pulse was 60 at AM 8:55. Patient escorted to exam room and monitored with head and feet elevated for additional 20 minutes. Blood pressure was 112/73 at 9:15 AM, patient was examined by doctor. Then patient was OK to leave facility without complaints of discomfort. Patient stated he was OK. Patient called office when he arrived home. This is one of several reports received from the same source. Additional information has been requested.


VAERS ID: 271115 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Vermont  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-01-16
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA02573

Write-up: Information has been received from a nurse practitioner concerning a 20 year old female with no medical history or allergies, who was vaccinated IM with 0.5 ml dose of Gardasil vaccine (yeast). Concomitant therapy included unspecified hormonal contraceptives (unspecified). Subsequently, the patient experienced severe injection site pain at the time of immunization. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


VAERS ID: 285464 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-02-22
Onset:2007-02-23
   Days after vaccination:1
Submitted: 2007-07-16
   Days after onset:142
Entered: 2007-07-18
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Chemotherapy, Dyspnoea, Oedema peripheral, Urticaria
SMQs:, Cardiac failure (broad), Anaphylactic reaction (narrow), Angioedema (narrow), Malignancy related therapeutic and diagnostic procedures (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA
Current Illness: Drug hypersensitivity; Acute lymphocytic leukaemia
Preexisting Conditions: Chemotherapy; Hives; Breathing difficult
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA02842

Write-up: Information has been received from a registered nurse concerning a 20 year old female with acute lymphocytic leukaemia treated with chemotherapy (1989) and a drug allergy to BENADRYL (hives, trouble breathing) who on 22-FEB-2007 at 10:00, was vaccinated IM into the left arm with a first dose of Gardasil (Lot# 654741/0013U). Concomitant therapy included DEPO-PROVERA. "Within a day or two later," the patient''s left forearm swelled from the injection site to the upper arm after lifting weights of 20 to 40 pounds. It was reported that the patient denied any erythema or itching. Unspecified medical attention was sought. No laboratory diagnostic studies were performed. After 2 to 3 days, the swelling resolved. It was also reported the patient has not yet received the second dose of the vaccine. No product quality complaint was involved. Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 7/16/2007; 10/8/2007. The day following immunization, the patient''s left upper arm and forearm swelled. The patient described that her forearm "swelled to the size of her upper arm". She noticed this after lifting weights (20-40 pounds). It was reported that the patient denied any itching, erythema, SOB, wheeezes or pain. Unspecified medical attention was sought. No laboratory diagnostic studies were performed. On 26-FEB-2007, the patient recovered. No product quality complaint was involved. Additional information is not expected.


VAERS ID: 325939 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-06-01
Onset:2008-06-18
   Days after vaccination:17
Submitted: 2008-08-14
   Days after onset:57
Entered: 2008-08-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Human papilloma virus test positive, Smear cervix abnormal
SMQs:

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: PROZAC
Current Illness: Anxiety disorder
Preexisting Conditions: Papanicolaou smear abnormal, Papilloma viral infection
Allergies:
Diagnostic Lab Data: Pap test - 06/18/08 - positive for HPV
CDC Split Type: WAES0807USA01544

Write-up: Information has been received from a physician concerning a 20 year old female with anxiety disorder and a history of papanicolaou smear abnormal and positive for HPV that resolved with no treatment and no drug allergies who in June 2008, was vaccinated with the third dose of GARDASIL vaccine (yeast). Concomitant therapy included PROZAC. On 18-JUN-2008, the patient had a Papanicolaou (PAP) that was positive for HPV. Medical attention was sought via office visit. No product quality complaint was involved. Additional information has been requested.


VAERS ID: 344963 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-04-10
Onset:2009-04-12
   Days after vaccination:2
Submitted: 2009-04-20
   Days after onset:8
Entered: 2009-04-27
   Days after submission:7
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1312X / 1 LL / IM

Administered by: Other       Purchased by: Private
Symptoms: Axillary pain, Lymph node pain
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Depo Provera
Current Illness: None
Preexisting Conditions: Beta Blockers, asthma, migraine with auva
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Pt received first GARDASIL injection 4/10/09. On 4/12/09, noted 1cm round tender axillary node.


VAERS ID: 298598 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-08-24
Onset:2007-09-08
   Days after vaccination:15
Submitted: 2007-10-12
   Days after onset:34
Entered: 2007-10-15
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Full blood count, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (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: TRINESSA
Current Illness:
Preexisting Conditions: Papanicolaou smear abnormal; Papilloma viral infection
Allergies:
Diagnostic Lab Data: complete blood cell, 09/??/07
CDC Split Type: WAES0709USA03745

Write-up: Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 22 year old female patient, with a history of an abnormal Papanicolaou smear and papilloma viral infection (HPV), who on 24-AUG-2007 was vaccinated IM with the first dose, 0.5 ml, of Gardasil (lot # not provided). Concomitant therapy included TRINESSA. On 08-SEP-2007, two weeks after the vaccination, the patient developed petechiae on her legs. The patient was seen by a physician, though treatment was not specified. At the time of this report, the patient was recovering. Additional information has been requested.


VAERS ID: 350017 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-06-18
Onset:2009-06-19
   Days after vaccination:1
Submitted: 2009-06-24
   Days after onset:5
Entered: 2009-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0653X / 1 RA / UN

Administered by: Unknown       Purchased by: Unknown
Symptoms: Abdominal discomfort, Dizziness, General physical health deterioration, Hyperhidrosis, Hypersomnia, Immediate post-injection reaction, Malaise, Presyncope, Tremor, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Gastrointestinal perforation, ulcer, haemorrhage, obstruction non-specific findings/procedures (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Depression (excl suicide and self injury) (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (narrow), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None Medical records received 6/29/09 PMH: nasal fx. Allergy: Keflex.
Allergies:
Diagnostic Lab Data: Medical records received 6/29/09 LABS: WBC 14.1(H), ANC 12.13(H)lymphs 8%(L).
CDC Split Type:

Write-up: Right after i recieved the vaccination i did not feel well and slept all afternoon i recieved the shot in the morning. I was vomitting, almost fainted, sweating uncontrollably. Then my whole body was shaking and would not stop. This happened the morning after i recieved the vaccination. I was very dizzy and had to go to the emergency room that afternoon to recieve medicine to stop shaking, vomitting. I stayed in bed for two days straight sleeping. I was very dizzy. Now I still have stomach issues and my body and health does not feel the same. 6/29/09 Received ER medical records for 6/19/2009. FINAL DX: Vaccine reaction Records reveal patient experienced dizziness, chills, shakiness, vomiting x 1, near syncope x 1 day. No previous reactions to immunizations. Tx w/IVF & meds. Improved & d/c tohome w/anti vertigo meds. 8/10/09 Received PCP medical records for 6/18-19/09 Records reveal patient on antidepressant & requesting BCP. Meds adjusted & vax provided. 6/19/09 reported lightheadedness & shaking jerky movements of UEs. Sent to ER.


VAERS ID: 313004 (history)  
Form: Version 1.0  
Age: 24.0  
Gender: Female  
Location: Vermont  
Vaccinated:2008-01-23
Onset:2008-01-24
   Days after vaccination:1
Submitted: 2008-05-16
   Days after onset:112
Entered: 2008-05-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0515U / 2 UN / IM

Administered by: Private       Purchased by: Public
Symptoms: Chills, Myalgia, Nausea, Pyrexia, Vaccine positive rechallenge, Vomiting
SMQs:, Rhabdomyolysis/myopathy (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: ORTHO-CYCLIN B, C, P
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Chills, fever, myalgias nausea vomiting 24 hours after GARDASIL vaccine after each dose #1 11-20-07 #2 1-23-08


VAERS ID: 285936 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-04-01
Onset:2007-04-01
   Days after vaccination:0
Submitted: 2007-07-16
   Days after onset:106
Entered: 2007-07-18
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Arrhythmia related investigations, signs and symptoms (broad), Extravasation events (injections, infusions and implants) (broad), Cardiomyopathy (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? Yes
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: WAES0706USA05340

Write-up: Information has been received from a 25 year old female who in April 2007, was vaccinated with a 0.5 ml second dose of Gardasil. Subsequently in April 2007 the patient fainted and had a moderate amount of injection site pain. Unspecified medical attention. Subsequently that same day, the patient recovered from the fainting and moderate amount of injection site pain. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 7/16/2007. Initial and follow-up information has been received from a 25 year old female and the doctors office, who in April 2007, was vaccinated with a 0.5 ml second dose of GARDASIL. Subsequently in April 2007 the patient fainted and had a moderate amount of injection site pain. Unspecified medical attention was sought. Subsequently that same day, the patient recovered from the fainting and moderate amount of injection site pain. Additional information is not expected.


VAERS ID: 515021 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Male  
Location: Vermont  
Vaccinated:2013-11-27
Onset:2013-11-27
   Days after vaccination:0
Submitted: 2013-11-27
   Days after onset:0
Entered: 2013-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J006236 / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Dizziness
SMQs:, Anticholinergic syndrome (broad), Vestibular disorders (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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient felt like fainting right after administration of vaccine. Just advised patient remain seated.


VAERS ID: 629452 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Vermont  
Vaccinated:2016-03-23
Onset:2016-03-24
   Days after vaccination:1
Submitted: 2016-03-24
   Days after onset:0
Entered: 2016-03-25
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L044475 / 3 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Injection site erythema, Injection site swelling, Injection site warmth, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (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: Wellbutrin
Current Illness:
Preexisting Conditions: NKDA; Seasonal depression
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Left deltoid with 4" x 5" red, warm, swollen area, distal to injection site. Symptoms started 1 day post injection worsened overnight into day 2 post injection. Some tingling in fingers with certain positions. Recommended ice, evaluation, ibuprofen, and BENADRYL


VAERS ID: 658708 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Vermont  
Vaccinated:2016-09-29
Onset:2016-10-02
   Days after vaccination:3
Submitted: 2016-10-04
   Days after onset:2
Entered: 2016-10-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. M011117 / 2 LA / UN

Administered by: Private       Purchased by: Public
Symptoms: Feeling abnormal, Pain in jaw
SMQs:, Dementia (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Jaw pain. She felt out of it that day HPV9 was given. 10/2/16 woke up with jaw pain (L) side that radiates.


VAERS ID: 403148 (history)  
Form: Version 1.0  
Age: 27.0  
Gender: Female  
Location: Vermont  
Vaccinated:2009-07-20
Onset:0000-00-00
Submitted: 2010-10-12
Entered: 2010-10-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0063X / 3 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Fatigue, Fibromyalgia, Irritable bowel syndrome
SMQs:, Noninfectious diarrhoea (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:
Current Illness: negative
Preexisting Conditions: depression; allergies
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: fibromyalgia, IBS, chronic fatigue


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