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This is VAERS ID 274722

Case Details

VAERS ID: 274722 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: New Mexico  
Vaccinated:2006-11-28
Onset:2006-11-29
   Days after vaccination:1
Submitted: 2007-03-14
   Days after onset:104
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: 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? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Cardiac murmur
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA04640

Write-up: Information has been received from a Registered Nurse (R.N.) concerning a 17 year old female with a cardiac murmur who on 28-NOV-2006 was vaccinated IM with her first dose of HPV, lot #654540/0800F. On 29-FEB-06 the patient experienced minor soreness around the injection site. The patient did not return for her 2nd dose until 27-FEB-2007. The patient recovered. Additional information has been requested.


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