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This is VAERS ID 272336

Case Details

VAERS ID: 272336 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: New Jersey  
   Days after vaccination:0
Submitted: 2007-02-14
   Days after onset:62
Entered: 2007-02-15
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Injected limb mobility decreased, Injection site pain, Pain in extremity
SMQs:, Extravasation events (injections, infusions and implants) (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0701USA01977

Write-up: Information has been received from a licensed practical nurse concerning a female who on 19-SEP-2006 was vaccinated intramuscularly (IM) with a first 0.5 ml dose of GARDASIL vaccine. Subsequently the patient experienced pain at the injection site. Unspecified medical attention was sought. It was reported that the patient did not return to complete the schedule. Additional information has been requested. This is in follow-up to report (s) previously received on 2/14/2007. On 14-DEC-2006, the patient was vaccinated with IM GARDASIL vaccine (lot # 654389/0961F) in the right deltoid. On 14-DEC-2006, the patient experienced pain in her arm, difficulty moving and lifting arm. The patient reported recovery from difficulty moving and lifting arm on 28-DEC-2006. The patient reported recovery from arm pain on 14-JAN-2007. Additional information is not expected.

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