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This is VAERS ID 284514

Case Details

VAERS ID: 284514 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:21
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Discomfort, Incorrect route of drug administration, Injection site haematoma
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Medication errors (narrow)

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
Diagnostic Lab Data:
CDC Split Type: WAES0705USA05443

Write-up: Information has been received from a medical assistant concerning a 16 year old female who on 24-MAY-2007 was vaccinated with Gardasil vaccine(yeast) subcutaneously. The patient experienced an injection site hematoma and reported the injection was "uncomfortable". Subsequently, the patient recovered. Additional information has been requested. This in follow-up to report(s) previuously submitted on 6/14/2007. Follow up information received from the medical assistant stated that on 25-MAY-2007, the patient developed a sight hematoma. It was reported that on an unspecified daie the patient had recovered and was "fine". Additional information is not expected.

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