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This is VAERS ID 272619

Case Details

VAERS ID: 272619 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Pennsylvania  
Vaccinated:2007-01-26
Onset:2007-01-27
   Days after vaccination:1
Submitted: 2007-02-14
   Days after onset:18
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655619/1427F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Pain in extremity, Paraesthesia
SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (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: sulfonamide allergy
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA00160

Write-up: Information has been received from a registered nurse from a hospital infusion center concerning a 22 year old female with sulfa allergy and no pertinent medical history who on 26-JAN-2007 was vaccinated with first dose of Gardasil (lot# 655619/1427F), 0.5 ml, IM in left deltoid. There was no concomitant medication. On 27-JAN-2007, Saturday morning, the patient called and reported she experienced pain at the injection site and the pain had increased. The patient sought medical attention. No diagnostic tests were performed. On 31-JAN-2007, the patient experienced pain and tingling down her left arm. At the time of reporting, the patient had no recovered. The patient was referred to her primary physician for follow-up. Additional information has been requested.


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