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This is VAERS ID 276110

Case Details

VAERS ID: 276110 (history)  
Age: 14.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2006-12-28
Onset:2006-12-28
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:98
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654389/0961F / 1 RA / IM

Administered by: Other       Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse effect
SMQs:, Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC Split Type: WAES0702USA00159

Write-up: Information has been received from a registered nurse concerning a 14 year old female with no pre-existing conditions who on 29, Nov 2006, was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 28, Dec 2006, the patient was vaccinated with second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 654389/0961F) IM right arm 30 days after the 1st dose. At the time of the vaccination, the patient had no illness. The patient did not experience adverse effects. No additional information is expected.


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