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This is VAERS ID 272484

Case Details

VAERS ID: 272484 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Alabama  
Vaccinated:2006-12-21
Onset:2006-12-21
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:55
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / -

Administered by: Other       Purchased by: Other
Symptoms: Injection site induration
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: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0701USA03182

Write-up: Information has been received from an office manager concerning a 16 year old female who on 21-DEC-2006 was vaccinated in the arm (unspecified) with the first dose of HPV vaccine (yeast). There was no concomitant medication. On approximately 21-DEC-2006, after receiving the vaccination, the patient developed a "knot" at the injection site. The patient sought unspecified medical attention. The "knot" at the patient''s injection site persisted. Additional information has been requested.


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