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This is VAERS ID 269252

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269252
VAERS Form:
Age:
Gender:Female
Location:Florida
Vaccinated:2006-11-22
Onset:2006-11-23
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pain, Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an approximately 19 year old female who on 22 Nov 2006 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast). On 23 Nov 2006, the patient experienced a sore arm for 2 days. It was noted tha"t it started to get better however on 27 Nov 2006 the pain at the injection site returned with radiating pain to the shoulder and shoulder blade. There was no redness or swelling at the site. The patient stated that /"it felt like a heavy weight is on my


Changed on 12/8/2009

269252 Before After
VAERS Form:
Age:
Gender:Female
Location:Florida
Vaccinated:2006-11-22
Onset:2006-11-23
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pain, Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0612USA00352

Write-up:Information has been received from a physician concerning an approximately 19 year old female who on 22 Nov 2006 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast). On 23 Nov 2006, the patient experienced a sore arm for 2 days. It was noted tha"t that it started to get better however on 27 Nov 2006 the pain at the injection site returned with radiating pain to the shoulder and shoulder blade. There was no redness or swelling at the site. The patient stated that /"it "it felt like a heavy weight is on my arm." Unspecified medical attention was sought. The patient''s pain at the injection site with radiating pain to the shoulder and shoulder blade persisted. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

269252 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Florida
Vaccinated:2006-11-22
Onset:2006-11-23
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Myalgia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00352

Write-up:Information has been received from a physician concerning an approximately 19 year old female who on 22 Nov 2006 was vaccinated with a 0.5 ml dose of Gardasil vaccine (yeast). On 23 Nov 2006, the patient experienced a sore arm for 2 days. It was noted that it started to get better however on 27 Nov 2006 the pain at the injection site returned with radiating pain to the shoulder and shoulder blade. There was no redness or swelling at the site. The patient stated that "it felt like a heavy weight is on my arm." Unspecified medical attention was sought. The patient''s pain at the injection site with radiating pain to the shoulder and shoulder blade persisted. No product quality complaint was involved. Additional information has been requested.


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