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This is VAERS ID 269696

Case Details

VAERS ID: 269696 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: New York  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2006-12-21
   Days after onset:0
Entered: 2006-12-27
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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

Write-up: Immediate after Gardasil given pt developed 4cm bright red area at injection site.


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