National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 264757

(NOTE: This result is from the 12/30/2006 version of the VAERS database)

Case Details

VAERS ID: 264757 (history)  
Form: Version .0  
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: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 653937/0637F / - - / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Injection site rash
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: hormonal contraception
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

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.


New Search

Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20061230&IDNUMBER=264757


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166