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This is VAERS ID 270246

Case Details

VAERS ID: 270246 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Ohio  
Vaccinated:2006-11-27
Onset:2006-11-27
   Days after vaccination:0
Submitted: 2007-01-05
   Days after onset:39
Entered: 2007-01-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 GM / IM

Administered by: Other       Purchased by: Other
Symptoms: Discomfort, Injection site discomfort, Injection site pain
SMQs:, 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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0612USA00441

Write-up: Information has been received from a registered nurse concerning her 19 year old daughter with no medical history or drug allergies who on 27 Nov 2006 was vaccinated intramuscularly in the mid top gluteal region with a first dose of HPV Vaccine. There was no concomitant medication. On 27 Nov 2006 the patient mentioned that the site of injection hurt and caused discomfort. The patient was uncomfortable for 24 hours. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. At the time of this report, the outcome was unknown. No product quality complaint was involved. Additional information has been requested.


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