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This is VAERS ID 276111

Case Details

VAERS ID: 276111 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Alabama  
Vaccinated:2007-02-16
Onset:2007-02-16
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:48
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Drug administered at inappropriate site, No adverse effect
SMQs:, Medication errors (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0702USA03810

Write-up: Information has been received from a nurse that on 16, Feb 2007, they administered a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) in a patient''s hip. No adverse event was reported. Additional information has been requested.


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