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This is VAERS ID 271104

Case Details

VAERS ID: 271104 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: New Jersey  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-01-16
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other       Purchased by: Other
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0612USA01717

Write-up: Information has been received from a physician concerning a 22 year old female who was vaccinated with a dose of Gardasil vaccine (yeast). Subsequently, after receiving the vaccination, the patient developed red lesions around the injection site on her arm. On an unspecified date, the patient recovered. Additional information has been requested.


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