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This is VAERS ID 277273

Case Details

VAERS ID: 277273 (history)  
Age: 15.0  
Gender: Female  
Location: Texas  
Vaccinated:2007-04-10
Onset:2007-04-13
   Days after vaccination:3
Submitted: 2007-04-19
   Days after onset:6
Entered: 2007-04-24
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 1 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Burning sensation, Haematoma, Injection site swelling, Skin reaction
SMQs:, Peripheral neuropathy (broad), Haemorrhage terms (excl laboratory terms) (narrow), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Skin reaction w/cresent shaped burn like reaction one week after 2nd dose of Gardasil. Swollen below injection site, probable hematoma.


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