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This is VAERS ID 274206

Case Details

VAERS ID: 274206 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: California  
Vaccinated:2007-01-22
Onset:2007-02-10
   Days after vaccination:19
Submitted: 2007-03-14
   Days after onset:31
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 UN / -

Administered by: Private       Purchased by: Other
Symptoms: Injection site bruising, Injection site rash, Nausea
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow)

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: Zelnorm
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA01736

Write-up: Information has been received from a registered nurse via a company representative, concerning a 25 year old female who on approximately 22-JAN-2007 (about three weeks ago), was vaccinated with the second dose of Gardasil, 0.5 ml. Concomitant therapy included ZELNORM. On approximately 10-FEB-2007 ("within the past day or two"), the patient developed "a bump and bruise at injection site, and nausea. It was reported that the patient had "no ill effects after the first dose" (date not provided). At the time of this report, the patient had not yet recovered. The patient sought unspecified medical attention. Additional information has been requested.


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