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This is VAERS ID 280174

Case Details

VAERS ID: 280174 (history)  
Form: Version 1.0  
Age: 21.0  
Gender: Female  
Location: California  
Vaccinated:2007-04-27
Onset:2007-06-01
   Days after vaccination:35
Submitted: 2007-06-03
   Days after onset:2
Entered: 2007-06-01
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384D / 2 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Cyst, Injection site cyst, Injection site pain, Skin lesion
SMQs:, Extravasation events (injections, infusions and implants) (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (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: None
Current Illness: None
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: L Deltoid cyst like lesion
CDC Split Type:

Write-up: L Deltoid area Cyst like lesion 0.5 x 0.5cm + tenderness 5 wks after vaccine placed.


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