VAERS ID: 261578

AGE: 21| SEX: F|STATE: FL (United States)

Description

Information has been received from a physician and registered nurse concerning a 21 year old female with no medical history of drug allergies who on 27-JUL-2006 was vaccinated intramuscularly in the left deltoid with the first dose of HPV rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). Concomitant therapy included possible hormonal contraceptives (unspecified). On 27-JUL-2006 the patient experienced extreme pain at the injection site. The onset of the pain was immediate and lasted for 5 to 6 minutes and then resolved. Unspecified medical attention was sought. It was reported that the patient does not wish to continue the series of vaccinations. Additional information has been requested.

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Symptoms

Injection site pain

Vaccines

VAX DATE: 07-27-2006| ONSET DATE: 07-27-2006| DAYS TO ONSET: 0
NameDose #TypeManufacturerLotRouteSite
HPV (GARDASIL) 1 HPV4 MERCK & CO. INC. 0702F IM

RECVDATE:08-15-2006
RPT_DATE:08-10-2006
CAGE_YR:21
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:Y
LAB_DATA:
V_ADMINBY:OTH
OTHER_MEDS:hormonal contraceptives
CUR_ILL:
HISTORY:
PRIOR_VAX:
SPLTTYPE:WAES0607USA05775
FORM_VERS:
TODAYS_DATE:
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:
V_FUNDBY:OTH

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