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Administered by: Other      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive, WBC count elevated 11/20/06.
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''''s office with HPV vaccine. Concomitant therapy included Zyrtec and o"ral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On

Changed on 12/8/2009

Administered by: Other      Purchased by: Unknown Other
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, White blood cell count increased, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive, positive; WBC count elevated 11/20/06.
CDC 'Split Type': (blank) WAES0611USA06121

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''''s OB/GYN''s office with HPV vaccine. Concomitant therapy included Zyrtec and o"ral oral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On 11/20/06 lab testing revealed a positive Rapid streptococcal test and the pt was placed on unspecified antibiotics. Other lab findings revealed a neg medical panel, a complete blood count revealed an elevated WBC count with a shift to the left, and a urinalysis was neg but with a trace hemoglobin. At the time of this report, the pt was recovering. The physician felt that one or more of the events were disabling. Additional information has been requested.

Changed on 6/14/2014

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, White blood cell count increased, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive; WBC count elevated 11/20/06.
CDC 'Split Type': WAES0611USA06121

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''s office with HPV vaccine. Concomitant therapy included Zyrtec and oral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On 11/20/06 lab testing revealed a positive Rapid streptococcal test and the pt was placed on unspecified antibiotics. Other lab findings revealed a neg medical panel, a complete blood count revealed an elevated WBC count with a shift to the left, and a urinalysis was neg but with a trace hemoglobin. At the time of this report, the pt was recovering. The physician felt that one or more of the events were disabling. Additional information has been requested.

Changed on 3/14/2015

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, White blood cell count increased, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive; WBC count elevated 11/20/06.
CDC 'Split Type': WAES0611USA06121

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''s office with HPV vaccine. Concomitant therapy included Zyrtec and oral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On 11/20/06 lab testing revealed a positive Rapid streptococcal test and the pt was placed on unspecified antibiotics. Other lab findings revealed a neg medical panel, a complete blood count revealed an elevated WBC count with a shift to the left, and a urinalysis was neg but with a trace hemoglobin. At the time of this report, the pt was recovering. The physician felt that one or more of the events were disabling. Additional information has been requested.

Changed on 9/14/2017

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, White blood cell count increased, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive; WBC count elevated 11/20/06.
CDC 'Split Type': WAES0611USA06121

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''s office with HPV vaccine. Concomitant therapy included Zyrtec and oral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On 11/20/06 lab testing revealed a positive Rapid streptococcal test and the pt was placed on unspecified antibiotics. Other lab findings revealed a neg medical panel, a complete blood count revealed an elevated WBC count with a shift to the left, and a urinalysis was neg but with a trace hemoglobin. At the time of this report, the pt was recovering. The physician felt that one or more of the events were disabling. Additional information has been requested.

Changed on 2/14/2018

Administered by: Other      Purchased by: Other
Symptoms: Laboratory test abnormal, Myalgia, Rash, Skin discolouration, White blood cell count increased, Bacterial infection

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive; WBC count elevated 11/20/06.
CDC 'Split Type': WAES0611USA06121

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''s office with HPV vaccine. Concomitant therapy included Zyrtec and oral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On 11/20/06 lab testing revealed a positive Rapid streptococcal test and the pt was placed on unspecified antibiotics. Other lab findings revealed a neg medical panel, a complete blood count revealed an elevated WBC count with a shift to the left, and a urinalysis was neg but with a trace hemoglobin. At the time of this report, the pt was recovering. The physician felt that one or more of the events were disabling. Additional information has been requested.

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