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This is VAERS ID 283738

Case Details

VAERS ID: 283738 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-04-19
Onset:2007-04-19
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:56
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (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: None
CDC Split Type: WAES0705USA00501

Write-up: Information has been received via a company representative, from a 22 year old female nursing assistant, who on 19-APR-2007 was vaccinated IM in the deltoid, with the first dose of Gardasil. The nursing assistant report she experienced pain in her deltoid muscle at the injections site, and pain that was radiating down her arm. At the time of this report, the nursing assistant had not recovered. The patient did not seek medical attention. No further information is expected.


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