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This is VAERS ID 274221

Case Details

VAERS ID: 274221 (history)  
Form: Version 1.0  
Age: 35.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-01-22
Onset:2007-01-22
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:50
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Inappropriate schedule of drug administration, Injection site calcification, Injection site pain, Injection site pruritus, Oedema peripheral
SMQs:, Cardiac failure (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (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: Penicillin allergy; Sulfonamide allergy
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA02476

Write-up: This is in follow-up to report(s) previously submitted on 3/14/2007 Initial and follow-up information has been received from a physician and a 35 year old female with penicillin and sulfonamide allergy with no pertinent medical history who on 22-JAN-2007 was vaccinated intramuscularly with a 0.5 ml first dose of GARDASIL. There was no concomitant medication. The patient reported that on 31-JAN-2007 she developed a painful itch at the injection site. The patient reported that after careful study of the site, she noted and then felt a bump at the injection site. The patient consulted with her physician who stated it was a calcification. Follow-up from the physician reported that on 08-FEB-2007 the patient developed a 1/2 cm tender firm lump at mid-humerus and was unsure if it was at the area of injection. Subsequently, the patient recovered. There were no laboratory or diagnostic tests performed. No additional information is available.


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