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This is VAERS ID 263239

Case Details

VAERS ID: 263239 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: North Carolina  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2006-09-14
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

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: WAES0609USA00041

Write-up: Information has been received from a registered nurse concerning 3 patients 9age and gender not reported) who on an unspecified date were vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently the patients developed injection site pain (date unknown). The patients sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested.


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