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This is VAERS ID 279186

Case Details

VAERS ID: 279186 (history)  
Age: 26.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-03
Onset:2007-04-07
   Days after vaccination:4
Submitted: 2007-05-14
   Days after onset:37
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0284U / 1 - / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA01617

Write-up: This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number "0284U" also reported as 0284J. invalid lot #). Concomitant therapy included SEASONIQUE. On 07-APR-2007 the patient experienced a 1 cm tender nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil. IM in her left delotid on 03-APR-2007 (previously reported as 04-APR-2007). The patient''s tender nodule persisted. The patient''s outcome was unknown. Additional information is not expected.


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