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This is VAERS ID 272940

Case Details

VAERS ID: 272940 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Florida  
   Days after vaccination:0
Submitted: 2007-02-22
   Days after onset:62
Entered: 2007-02-23
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Insomnia, Medical device complication, Musculoskeletal pain, Pain, X-ray normal
SMQs:, Rhabdomyolysis/myopathy (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: X-ray 02/12?/07 - No bony abnormalities
CDC Split Type: WAES0702USA03448

Write-up: Information has been received from a physician and an office manager concerning a 17 year old female with asthma who on 22-DEC-2006 was vaccinated IM, into the left arm, with a 0.5 ml first dose of Gardasil (lot#654540/0800P). It was reported that at the end of the administration the "safety spring plunger snapped back and caused the patient pain." The office manager explained that this incident was due to human error, the physician was unfamiliar with safety mechanism. On 22-DEC-2006, the patient experienced left shoulder pain and difficulty sleeping on her left arm. On approximately 12-FEB-2007, the patient saw an orthopedic surgeon. The patient underwent an X-ray which revealed no bony abnormality. The orthopedic surgeon recommended that the patient go to physical therapy. At the time of the report, the patient had not recovered. The physician considered the left shoulder pain and difficulty sleeping on her left arm to be disabling events. Additional information has been requested.

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