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This is VAERS ID 264757

Case Details

VAERS ID: 264757 (history)  
Age: 25.0  
Gender: Female  
Location: Missouri  
Vaccinated:2006-09-01
Onset:2006-09-08
   Days after vaccination:7
Submitted: 2006-10-13
   Days after onset:35
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 653937/0637F / - - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site rash
SMQs:, Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraception
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC Split Type: WAES0609USA05017

Write-up: Information has been received from a physician and a registered nurse concerning a 25 year old female who on 01-SEP-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 08-SEP-2006, one week after vaccination, the patient developed "small bumps under her skin" at the injection site. The patient sought unspecified medical attention. Subsequently, the patient fully recovered.


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