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This is VAERS ID 284538

Case Details

VAERS ID: 284538 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: Kansas  
Vaccinated:2007-05-29
Onset:2007-05-29
   Days after vaccination:0
Submitted: 2007-06-14
   Days after onset:16
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Injection site swelling
SMQs:, Extravasation events (injections, infusions and implants) (broad), 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: MENACTRA
Current Illness: Urinary tract infection
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA05748

Write-up: Information has been received from a physician concerning a female patient with a urinary tract infection who on 29-MAY-2007 was vaccinated IM with Gardasil. Concomitant therapy included Menactra. That same day, the patient experienced pain and swelling at the injection site. The patient sought unspecified medical attention. Additional information has been requested.


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