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This is VAERS ID 263241

Case Details

VAERS ID: 263241 (history)  
Age: 24.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2006-08-29
Onset:2006-08-29
   Days after vaccination:0
Submitted: 2006-09-14
   Days after onset:16
Entered: 2006-09-19
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0589F / 0 LA / -

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Unknown
Preexisting Conditions: Unknown
Diagnostic Lab Data: NONE
CDC Split Type: WAES0609USA00077

Write-up: Information has been received from a physician concerning a female patient in her early 20''s who was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced a high amount of pain and swelling at the injection site. Medical attention was sought. Subsequently, the patient recovered. Additional information has been requested. 01/05/2007 Follow up information has been received from a physician concerning a 24 year old female who on 29-AUG-2006 at 9:00 a.m. was vaccinated in the left arm with her first dose of GARDASIL, lot #653736/0589F. Concomitant therapy included AMBIEN, doxycycline, ALLEGRA-D, and unspecified oral contraceptive pills. Following the vaccination, on 29-AUG-2006 at 9:00 a.m. the patient experienced pain (burning) in her left arm plus swelling and tenderness x 3 days. Additional information is not expected.


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