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This is VAERS ID 279222

Case Details

VAERS ID: 279222 (history)  
Form: Version 1.0  
Age: 27.0  
Gender: Female  
Location: Arizona  
Vaccinated:0000-00-00
Onset:2007-04-01
Submitted: 2007-05-14
   Days after onset:43
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: Inappropriate schedule of drug administration, Injection site erythema, Injection site swelling, Injection site warmth
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Medication errors (narrow)

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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0704USA02851

Write-up: Information has been received from a Medical Assistant (M.A.) concerning a 27 year old female patient who was vaccinated on 04-APR-2007 in to deltoid with a third dose of Gardasil lot #656049/0187U one week earlier than the recommended schedule. Concomitant therapy included prenatal vitamins (manufacturer unknown). After the third injection, the injection site area was "swollen, red and warm to touch". The size of the area was a 6 inch circumference. The patient sought unspecified medical attention. Her outcome was unknown at time of this report. Additional information has been requested.


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