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This is VAERS ID 279199

Case Details

VAERS ID: 279199 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Ohio  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-05-14
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: Immediate post-injection reaction, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA02264

Write-up: Information has been received from a nurse concerning a "4th grader" female patient who was vaccinated with a first dose of Gardasil. The patient experienced pain in the injection site right after receiving her injection. It was unknown if she sought medical attention. The outcome was unknown at the time of this report. Additional information is not expected.


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