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This is VAERS ID 283807

Case Details

VAERS ID: 283807 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Michigan  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Incorrect route of drug administration, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA02034

Write-up: Information has been received from a physician concerning a teenage female who received her first and second doses of Gardasil in the buttocks. Subsequently the patient experienced pain at the site for a unspecified duration. Subsequently, the patient recovered from pain. Unspecified medical attention was sought. Additional information has been requested.


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