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This is VAERS ID 264366

Case Details

VAERS ID: 264366 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Texas  
Vaccinated:2006-08-10
Onset:0000-00-00
Submitted: 2006-10-06
Entered: 2006-10-11
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Injection site pain, Joint range of motion decreased
SMQs:, Extravasation events (injections, infusions and implants) (broad), Arthritis (broad), Tendinopathies and ligament disorders (broad)

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: NONE
CDC Split Type: WAES0609USA00433

Write-up: Information has been received from a physician concerning a 19 year old female who in early August 2006, was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml). The physician reported that at the time of vaccination, the patient experienced injection site pain. The patient later experienced decreased range of motion in the arm she received the vaccination. It was reported that the patient''s arm hurt when she raised it above her head. At the time of this report, the patient''s injection site pain, decreased range of motion in arm pain persisted. Unspecified medical attention was sought. Additional information has been requested.


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