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This is VAERS ID 283766

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 283766
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0089U / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site pain, Injection site vesicles

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA; FLAGYL
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA01113

Write-up:Information has been received from a nurse practitioner concerning an 18 year old white female who on 11-APR-2007 at 15:00 was vaccinated, intramuscularly in the right deltoid, with a first 0.5 ml dose of Gardasil (Lot #655324/0089U). Concomitant therapy included medroxyprogesterone acetate (DEPO-PROVERA) and metronidazole (FLAGYL). On 11-APR-2007, several hours after the vaccination, the patient developed a blister-like reaction at the injection site and at 15:00 experienced prolonged injection site pain (for three weeks). At the time of this report the patient''s outcome for blister-like reaction at injection site was unknown. No product quality complaint was involved. Additional information is not expected.


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