National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279173

Case Details

VAERS ID: 279173 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-01-03
Onset:2007-01-03
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:130
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Pain in extremity
SMQs:, Tendinopathies and ligament disorders (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:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01334

Write-up: Information has been received from a Registered Nurse (R.N.) concerning her 20 year old daughter who on 03-JAN-2007 was vaccinated with a first dose 0.5 mL of Gardasil. Concomitant therapy included influenza virus vaccine (unspecified) and tetanus toxoid given in opposite arm where the Gardasil was given. On 03-JAN-2007 the patient experienced pain in the arm (which arm unknown) after receiving the first injection. As of 09-APR-2007 the patient had not received the second dose of Gardasil. Unspecified medical attention was sought. On 04-JAN-2007 the patient recovered. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279173


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