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This is VAERS ID 264696

Case Details

VAERS ID: 264696 (history)  
Age:   
Gender: Female  
Location: New Hampshire  
Vaccinated:2006-09-27
Onset:2006-09-27
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:16
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Medication error
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0609USA07424

Write-up: Information has been received from a registered nurse concerning a female (age not reported) with on known allergies or adverse drug reactions reported. On 9/27/06, the pt was vaccinated IM in the left deltoid with 1 ml (2 vials) of HPV vaccine (lot 0B37F). Concomitant therapy included a tetanus toxoid shot in the other arm. Subsequently, the pt experienced arm hurting. The registered nurse confirmed that the pain was at the injection site. The pt has not mentioned any other symptoms. The pt sought unspecified medical attention. The intervention to prevent serious criteria was 800 mg, of Motrin. The registered nurse reported that she did not know if the event would have worsened or improved without the intervention of Motrin. On 9/28/06, the pt returned to the physicians office and was fine, however her arm still hurt. At the time of this report, the pt had not recovered from the event. The reporter considered the event to be serious as an other important medical event (OMIC). Additional information has been requested.


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