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This is VAERS ID 276247

Case Details

VAERS ID: 276247 (history)  
Form: Version 1.0  
Age:   
Gender: Unknown  
Location: Unknown  
Vaccinated:2007-02-19
Onset:2007-02-19
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:45
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / UNK UN / -

Administered by: Other       Purchased by: Other
Symptoms: Drug administered at inappropriate site
SMQs:, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA04415

Write-up: Information has been received from a physician concerning a patient (age and gender unknown) who on 19-FEB-2007 was vaccinated with Gardasil (Lot number 654540/0800F). On 16-FEB-2007 the patient the received vaccine in the bottom. No further information is available.


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