National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284132

Case Details

VAERS ID: 284132 (history)  
Age: 17.0  
Gender: Female  
Location: California  
Vaccinated:2007-05-03
Onset:2007-05-03
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:42
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 GM / IM

Administered by: Private       Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pruritus
SMQs:, Extravasation events (injections, infusions and implants) (broad), Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA03167

Write-up: Information has been received from a medical assistant concerning a 17 year old female who on 03-MAY-2007 was vaccinated with first dose of Gardasil (lot # 657622/0388U) IM in the right gluteal muscle. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a medical assistant concerning a 17 year old female with no illness at the time of vaccination and no history of allergies or medical conditions who on 03-MAY-2007 was vaccinated with first dose of GARDASIL (lot # 657622/0388U) IM in the right gluteal muscle at approximately 2 PM. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient had recovered. Additional information was received from a family nurse practitioner who reported that the outcome of the events was unknown (previously stated as recovered). No additional information is expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284132


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166