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This is VAERS ID 274197

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 274197 (history)  
Form: Version .0  
Age: 14.0  
Sex: Female  
Location: Texas  
Vaccinated:2007-02-08
Onset:2007-02-08
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:33
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - LA / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Incorrect dose administered, Injection site reaction, Medical device complication, Pain in extremity, Skin irritation
SMQs:

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: Ortho Tri Cyclen Lo, Synthroid
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Information has been received from a licensed visiting nurse concerning a 14 year old female with no medical history and no known drug allergies, who on 08 Feb 2007 was vaccinated IM with a dose of Gardasil. Concomitant therapy included Ortho Tri Cyclen"Lo and Synthroid. The patient inadvertently received less than the recommended dose and experienced an injection site reaction. The nurse withdrew the vaccine from a vial and the medication leaked near the hub of the syringe while administering it to the


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