Age: 19.0
Sex: F
Vaccine: HPV4
Symptoms: Smear cervix abnormal, Tricuspid valve incompetence
Clinical narrative: Information has been received from a nurse concerning a 20 year old female with a history of cervical dysplasia and abnormal PAP, who in July 2007, was vaccinated with the first dose of GARDASIL vaccine (yeast). In September 2007, she was vaccinated with the second dose of GARDASIL vaccine (yeast) and in January 2008, she was vaccinated with the third dose of GARDASIL vaccine (yeast). The nurse reported that the patient developed persistent dizziness with occasional nausea after receiving the vaccine. The dizziness and nausea began in November 2007. The patient's persistent dizziness and occasional nausea persisted. Additional information has been requested.  10/1/08 Office notes received from PCP. Pt presented 1/3/08 with c/o nausea and dizziness.  Nausea began 11/07 and dizziness several weeks ago. Feels like sesation of passing out.  Nausea is constant. PE WNL. Assessment:  Gastritis, new.  Dizziness, new.  Nausea, new.  Non-specific reaction to Tuberculin skin test w/o active TB, new. Tx with meds. Returned 6/25/08 with c/o worsening dizziness and lightheadedness which is interfering with QOL.  Nausea improved. Weakness noted during pre-syncopal spells.  Assessment:  Dizziness, worsening.  Nausea, stable. Plan to refer to cardiology, however office does not have consult name.  10/09/2008 Cardiology consult received for 7/7/2008 with Dx: Abnormal EKG.  Dizziness and Giddiness.  Syncope/Collapse.  Disturbance of Vision.  Nausea alone. PE (+) for flow murmur. Referred to ophth for black spots in visual field. Enc to increase salt intake.  11/03/2008 Neurology consult received dated 7/10/08. Pt reports ~6 month hx of dizziness, feeling like pt will faint w/o LOC.  Brought on by standing quickly. PE WNL with BP drop from 100/80 to 96/80 with standing.  This is in follow-up to report(s) previously submitted on 8/14/2008. Information has been received from a nurse concerning a 20 year old female with a history of cervical dyplasia and abnormal PA, who in July 2007, was vaccinated with the first dose of GARDASIL vaccine (yeast). In September 2007, she was vaccinated with the second dose of GARDASIL vaccine (yeast) and in January 2008, she was vaccinated with the third dose of GARDASIL vaccine (yeast). The nurse reported that the patient developed persistent dizziness with occasional nausea after receiving the vaccine. The patient had an unspecified blood test at primary physician's office "within normal limits". The dizziness and nausea began in November 2007. The patient's persistent dizziness and occasional nausea persieted. Follow up information was received froma aregistered nurse concerning a 20 year old female patient with mild dysplasia a nd no known allergies who on 05-JUL-2007 was vaccinated intramuscularly into the left buttock with a first dose of GARDASIL vaccine (yeast (Lot # 658100/0525UI. 0.5 ml on 07-SEP-2007 was vaccinated intramuscularly into the upper right arm with a second dose of GARDASIL vaccine(yeast) (Lot # 658558/1061U)0.5 ml and on 02-JAN-2008 was vaccinated intramuscularly into the upper left arm with a third dose of GARDASIL vaccine (yeast) (lot # 659653/1448U). Patient complained of nausea and dizziness for 11 months. Patient was dizzy all the time andnausea came occasionally. Patient saw primary care physician in January 2008 , all labs were negative. Patient saw cardiologist and neurologist. All was ngative (the results were not sent to the reporting physician's office). The events reqired emergency room/doctor visit. At the time of reporting the patient had not receovered. There was no illness at the time of vaccination. Laboratory data: results not provided. No further information is available.