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This is VAERS ID 264756

Case Details

VAERS ID: 264756 (history)  
Form: Version 1.0  
Age: 23.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-09-18
Onset:2006-09-18
   Days after vaccination:0
Submitted: 2006-10-13
   Days after onset:25
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / UNK UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site reaction
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0609USA05009

Write-up: Information has been received from a nurse practitioner concerning a female who on 18-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced injection site reaction. The patient sought unspecified medical attention. Injection site reaction persists. Additional information has been requested.


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