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This is VAERS ID 274572

Case Details

VAERS ID: 274572 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Maryland  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:39
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Headache, Inappropriate schedule of drug administration, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (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: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type: WAES0702USA03856

Write-up: Information has been received from a registered nurse concerning a 14 year old female with no medical history and no allergies who on 02-FEB-2007 was vaccinated with a second dose of HPV (lot # 655503/00120), intramuscularly. The first dose of GARDASIL was given on 27-Oct-2006. There was no concomitant medication. On 02-FEB-2007 the patient experienced intermittent headache and soreness at the injection site of the left arm. The patient was examined by the physician on 20-FEB-2007 and was recommended Tylenol. The patient''s symptoms lasted for three weeks after which she recovered. No product quality complaint was involved. It was noted that the first dose of HPV was received on 27-OCT-2006. At the time of the report, the patient was considered to be not recovered. Additional information has been requested.

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