National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 276654

Case Details

VAERS ID: 276654 (history)  
Form: Version 1.0  
Age: 26.0  
Gender: Female  
Location: California  
Vaccinated:2007-01-12
Onset:2007-01-12
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:90
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site scar
SMQs:

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Latex allergy
Allergies:
Diagnostic Lab Data: Unk
CDC Split Type: WAES0703USA02090

Write-up: Information has been received from a health professional concerning a 26 year old female patient, who on 12-JAN-2007 was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot# 655617/1447F). Concomitant therapy included hormonal contraceptives (unspecified). On 12-JAN-2007 the patient developed "a 4mm dimple/scar on her arm." The patient sought unspecified medical attention. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276654


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166