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This is VAERS ID 279503

Case Details

VAERS ID: 279503 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:146
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1161F / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

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: albuterol, YASMIN, IMITREX TABLETS, ZOMIG
Current Illness: Asthma, Polycystic ovaries; Migraine
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0704USA04291

Write-up: Information has been received from a registered nurse, concerning a 21 year old female student with asthma, polycystic ovaries and migraines, who on 18-DEC-2006 was vaccinated IM in the gluteal area, with the second dose, 0.5ml, of Gardasil (Lot #654540/1161F). Concomitant therapy included Yasmin, Zomig, Imitrex tablets and albuterol inhaler. The nurse reported that the patient complained of pain at the injection site. At the time of this report, the nurse confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. Additional information has been requested.

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