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This is VAERS ID 276113

Case Details

VAERS ID: 276113 (history)  
Form: Version 1.0  
Age: 40.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-02-27
Onset:2007-02-27
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:37
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

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? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: estrogens (unspecified)
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00227

Write-up: Information has been received from a nurse practitioner (NP) concerning a 40 year old female who on 27, Feb 2007 was vaccinated with the first dose, 0.5 ml, of HPV rL1 6 11 16 18 VLP vaccine (yeast). concomitant therapy included estrogens (unspecified. On 27, Feb 2007, "starting a short time after her first dose, "the NP reported that the patient experienced pain at the injection site. At the time of this report, the patient was recovering from the event. The patient sought unspecified medical attention. Additional information has been requested.


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