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This is VAERS ID 279525

Case Details

VAERS ID: 279525 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Texas  
Vaccinated:2006-08-01
Onset:2006-08-01
   Days after vaccination:0
Submitted: 2007-05-14
   Days after onset:286
Entered: 2007-05-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Private       Purchased by: Private
Symptoms: Scar, Skin discolouration
SMQs:, Hypotonic-hyporesponsive episode (broad)

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: WAES0704USA04711

Write-up: Information has been received from a nurse concerning a 20 year old white female student who in August 2006, was vaccinated with a first dose of Gardasil. In August 2006, the patient developed discoloration and circular scarring. In November 2006, the patient was vaccinated with a second dose of Gardasil. At the time of the report, the patient''s outcome was unknown. No further information is available.


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