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This is VAERS ID 271111

Case Details

VAERS ID: 271111 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Unknown  
Vaccinated:2006-10-26
Onset:2006-10-26
   Days after vaccination:0
Submitted: 2007-01-16
   Days after onset:82
Entered: 2007-01-22
   Days after submission:6
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site irritation
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC Split Type: WAES0612USA02408

Write-up: Information has been received from a consumer concerning her 11 year old daughter who on 26-Oct-2006 was vaccinated IM with "one shot" of Gardasil vaccine (yeast). The patient felt like it was burning. She is recovering on an unspecified therapy. No further information is available.


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