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This is VAERS ID 284545

Case Details

VAERS ID: 284545 (history)  
Form: Version 1.0  
Age: 22.0  
Gender: Female  
Location: Unknown  
Vaccinated:2007-03-14
Onset:2007-04-16
   Days after vaccination:33
Submitted: 2007-06-14
   Days after onset:59
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 2 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain
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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: Adverse drug reaction
Allergies:
Diagnostic Lab Data: None
CDC Split Type: WAES0706USA0011

Write-up: Information has been received from a physician''s assistant concerning a 22 year old female with a history of an unspecified reaction to Lortab who on 14-MAR-2007 was vaccinated with her second dose of Gardasil (lot# 657617/0384U). Concomitant therapy included unspecified birth control. The patient experienced pain at the injection site. As of 31-MAY-2007 she was recovering. Additional information has been requested.


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