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This is VAERS ID 270257

Case Details

VAERS ID: 270257 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-01-05
   Days after onset:142
Entered: 2007-01-09
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
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? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0612USA00928

Write-up: Initial and follow up information has been received from an RN concerning an 18 year old white female student who on 16 Aug 2006 was vaccinated with her first dose of Gardasil (yeast). It was reported that she experienced pain at injection site several days post injection. On 13 Oct 2006 the patient received her second dose of Gardasil (yeast), IM, lot #653736/0689F. After the injection the patient complained of pain at injection site with radiating pain even at shoulder blade area several days post injection. Medical attention was sought. On 16 Oct 2006 the patient recovered from injection site pain and radiating pain. Additional information is not expected.

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