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This is VAERS ID 272628

Case Details

VAERS ID: 272628 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2007-01-12
Onset:2007-01-14
   Days after vaccination:2
Submitted: 2007-02-14
   Days after onset:31
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / -

Administered by: Other       Purchased by: Other
Symptoms: Pain, Skin lesion
SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (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: WAES0702USA00274

Write-up: Information has been received from a physician concerning a female patient who on 12-JAN-2007 was vaccinated with a dose of HPV vaccine. On 14-JAN-2007 the patient experienced painful raised lesions on the arm where the vaccine was administered. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested.


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