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This is VAERS ID 284136

Case Details

VAERS ID: 284136 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Unknown  
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. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site erythema, Injection site swelling, Nausea
SMQs:, Acute pancreatitis (broad), Extravasation events (injections, infusions and implants) (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Haemodynamic oedema, effusions and fluid overload (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0705USA03179

Write-up: Information has been received from a nurse practitioner concerning a female who on 03-MAY-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). On approximately 03-MAY-2007, the injection site became red and swollen and the patient experienced nausea. The patient sought unspecified medical attention. At the time of this report, the patient was not recovered. Additional information has been requested.


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