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This is VAERS ID 284129

Case Details

VAERS ID: 284129 (history)  
Age:   
Gender: Female  
Location: Illinois  
Vaccinated:2007-01-01
Onset:2007-01-01
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:163
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site urticaria
SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03136

Write-up: Information has been received from a physician, via a company representative, concerning a female patient who in January 2007, was vaccinated IM in the deltoid, with a dose, 0.5ml, of Gardasil. In January 2007, the patient developed a "large circular size welt at the injection site." At the time of this report, it was unknown if the patient had recovered. The patient sought unspecified medical attention. Additional information has been requested.


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