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This is VAERS ID 279054

Case Details

VAERS ID: 279054 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-02
Onset:2007-04-02
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:42
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC Split Type: WAES0704USA00601

Write-up: Information has been received from a nurse practitioner concerning a female who on 02-APR-2007 was vaccinated with a first dose of Gardasil. On 02-APR-2007 the patient experienced soreness at the injection site. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


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