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This is VAERS ID 284475

Case Details

VAERS ID: 284475 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Florida  
Vaccinated:2007-05-16
Onset:2007-05-16
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:29
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / UNK UN / IM

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

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: YAZ
Current Illness:
Preexisting Conditions: Seasonal allergy
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0705USA04401

Write-up: Information has been received from a health professional concerning a 25 year old female with a history of seasonal allergy who on 16-MAY-2007 was vaccinated IM with Gardasil (Lot #656051/0244U). Concomitant therapy included drospirenone (+) ethinyl estradiol (YAZ). On 16-MAY-2007 the patient developed a lump at the injection site. As of 23-MAY-2007, the patient had not recovered. Additional information has been requested.


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