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This is VAERS ID 283969

Case Details

VAERS ID: 283969 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Unknown  
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. - / 1 UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
SMQs:, Extravasation events (injections, infusions and implants) (broad)

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: WAES0705USA02942

Write-up: Information has been received from a registered nurse concerning a 20 year old female who was vaccinated with Gardasil. Subsequently the patient experienced pain around the injection site for 10 days. Medical attention was sought. Subsequently, the patient recovered. No product quality complaint was involved. Additional information has been requested.


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