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This is VAERS ID 272480

Case Details

VAERS ID: 272480 (history)  
Age: 21.0  
Gender: Female  
Location: Virginia  
Vaccinated:2006-11-08
Onset:2006-11-08
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:98
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: MINOCIN
Current Illness: Acne
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA03029

Write-up: Information has been received from a registered nurse concerning a 21 year old female with no past medical history and no drug allergies who on 08-NOV-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot# 653978/0955F) (0.5 ml), intramuscularly in the left deltoid. Concomitant therapy included minocycline HCl (MINOCIN). On 08-NOV-2006 the patient experienced skin discoloration around injection site. The discoloration was slightly lighter than her skin color and was shaped like a "C" to the other side was 20 mm. The area was not raised or sore. She mentioned that she had some mild soreness at the injection site for one to two days after the vaccine was initially administered. The patient had no other symptoms. There were no relevant diagnostic tests performed. Unspecified medical attention was sought. Additional information has been requested. This is in follow-up to report(s) previously submitted on 2/14/2007. Information has been received from a registered nurse concerning a 21 year old female with acne and no drug allergies who on 08-NOV-2006 at 1:20 PM was vaccinated with a first dose of GARDASIL (lot # 653978/0955F) (0.5 ml), intramuscularly in the left deltoid. Concomitant therapy included MINOCIN. On 08-NOV-2006 the patient experienced skin discoloration around left deltoid (injection site). The discoloration was slightly lighter than her skin color and was shaped like a "C" to the other side was 20 mm. The area was not raised or sore. She mentioned that she had some mild soreness at the injection site for one to two days after the vaccine was initially administered. The patient had no other symptoms. The area was still noticed approximately 8 weeks after vaccination, and denied other adverse reactions. Subsequently on 26-JAN-2007, the area was inspected. C shape was now a complete circle with center the same color as surrounding skin. After close inspection, the area was the same size and shape by Band aide used to cover injection site with lightened area corresponding to the adhesive on the Band aide. The patient received a second dose of GARDASIL on 26-JAN-2007. There were no noticeable skin changes at the time of the report. There were no relevant diagnostic tests performed. it was reported to be unknown if the patient recovered. Additional information has been requested.


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