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This is VAERS ID 279058

Case Details

VAERS ID: 279058 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Florida  
Vaccinated:2007-02-20
Onset:2007-02-20
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:82
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 erythema, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC Split Type: WAES0704USA00671

Write-up: Information has been received from a nurse practitioner concerning a female (age not reported) who on approximately 20-FEB-2007 (approximately 6 weeks ago) was vaccinated with the first dose of Gardasil, injection. Concomitant medication was not reported. On 20-FEB-2007 (approximately 6 weeks ago), the patient developed erythema in the arm in which she was vaccinated as well as a pruritic rash. The symptoms developed the same day she was vaccinated. The patient sought unspecified medical attention. Subsequently, the patient recovered from erythema arm and pruritic rash approximately 36 hours later. Additional information has been requested.


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