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From the 1/7/2021 release of VAERS data:

This is VAERS ID 269164

Case Details

VAERS ID: 269164 (history)  
Form: Version 1.0  
Age: 48.0  
Sex: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2006-12-14
   Days after onset:44
Entered: 2006-12-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Haemorrhage, Injection site induration
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin
Current Illness:
Preexisting Conditions: Condyloma, dysplasia
Diagnostic Lab Data: UNK
CDC Split Type: WAES0611USA00994

Write-up: Information has been received from a health professional concerning an approximately 48 year old female patient with condyloma with mild to moderate dysplasia who on 31 Oct 2006 was vaccinated IM into the deltoid with a second 0.5mL dose of Gardasil (yeast) (lot # 653978/0955F). Concomitant therapy included aspirin. It was reported that after the nurse gave the injection blood immediately ran out of the site and it was hard and lumpy. It was reported that the nurse used proper placement technique and a standard 1 inch needle (not the prefilled device). The patient had no problems with the first dose. The patient did not report any discomfort from the hard and lumpy area. The patient sought unspecified medical attention. Additional information has been requested.

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