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This is VAERS ID 263214

Case Details

VAERS ID: 263214 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2006-08-16
Onset:2006-08-16
   Days after vaccination:0
Submitted: 2006-09-14
   Days after onset:29
Entered: 2006-09-19
   Days after submission:5
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? No
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: WAES0608USA04456

Write-up: Information has been received from a registered nurse concerning an 18 year old female who on 16-AUG-2006 was vaccinated intramuscularly in the deltoid with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml). The patient subsequently experienced severe injection site pain. It was reported that the patient remarked that the injection really hurt and that the pain flew down her arm. The patient rubbed her arm for a few minutes after receiving the injection. The patient subsequently went home and the nurse had not heard back from the patient. The patient was to be followed by her physician''s office. The nurse also reported that she had not agitated the syringe prior to injection. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


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