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This is VAERS ID 264775

Case Details

VAERS ID: 264775 (history)  
Form: Version 1.0  
Age: 25.0  
Gender: Female  
Location: Colorado  
Submitted: 2006-10-13
Entered: 2006-10-17
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Medication error, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Medication errors (narrow)

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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC Split Type: WAES0609USA08561

Write-up: Information has been received from a registered nurse concerning a 25 year old female who in 2006 (date not reported) was vaccinated with a 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). The nurse reported having "the syringe jam and could not administer the vaccine." The vaccine was given using a second syringe. The nurse also reported that the patient experienced "muscle pain in her arm, the arm of the jammed syringe." At the time of this report, the patient had not recovered. Additional information has been requested.

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