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This is VAERS ID 263370

Case Details

VAERS ID: 263370 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Kansas  
Vaccinated:2006-08-24
Onset:2006-08-25
   Days after vaccination:1
Submitted: 2006-09-21
   Days after onset:27
Entered: 2006-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 GM / IM

Administered by: Private       Purchased by: Other
Symptoms: Breast disorder female, Tenderness
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: Ortho Tri cyclen LO x 6 years.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Extreme Breast tenderness x 4 days.


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