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This is VAERS ID 272616

Case Details

VAERS ID: 272616 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: New York  
Vaccinated:2007-01-22
Onset:2007-01-29
   Days after vaccination:7
Submitted: 2007-04-06
   Days after onset:66
Entered: 2007-02-15
   Days after submission:49
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655617/1447F / 2 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Injection site erythema, Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA00144

Write-up: Information has been received from a physician concerning a 15 year old female with no past medical history who on 22-JAN-2007 was vaccinated IM with a second 0.5 ml dose of HPV vaccine (yeast) (lot #655617/1447F). There was no concomitant medication. On 29-JAN-2007 the patient developed erythema and mild tenderness at the site of injection. There was no fever. She sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/14/2007. Initial and follow up information has been received from a physician concering a 15 year old female student with no past medical history and no adverse events following prior vaccinations who on 22-JAN-2007 was vaccinated IM with a second 0.5ml dose of GARDASIL (lot # 655617/1447F). There was no concomitant medication. On 29-JAN-2007 the patient developed erythema, swelling and mild tenderness at the site of injection. There was no fever. She recovered on an unspecified date. Additional information is not expected.


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