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This is VAERS ID 263930

Case Details

VAERS ID: 263930 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Rhode Island  
Vaccinated:2006-09-28
Onset:2006-09-28
   Days after vaccination:0
Submitted: 2006-10-03
   Days after onset:5
Entered: 2006-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08001F / 1 LA / IM

Administered by: Military       Purchased by: Military
Symptoms: Injection site warmth, Pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

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

Write-up: FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.


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