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This is VAERS ID 274069

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274069
VAERS Form:
Age:11.0
Gender:Female
Location:Washington
Vaccinated:2007-02-08
Onset:2007-02-18
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Crying, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: METADATE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a medical assistant and a nurse practitioner concerning an 11 year old female with no relevant medical history reported who on 08-FEB-2007 was vaccinated intramuscularly in the right deltoid wit a 0.5 ml dose of Gardasil"(lot 654702/0011U). Concomitant therapy included METADATE. On approximately 18-FEB-2007 or 19-FEB-2007, the patient developed upper right arm pain. The patient was seen on 21-FEB-2007 and 02-MAR-2007 for the upper arm pain. The pain occurred on the whole


Changed on 12/8/2009

274069 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Washington
Vaccinated:2007-02-08
Onset:2007-02-18
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Crying, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: METADATE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0703USA01160

Write-up:Information has been received from a medical assistant and a nurse practitioner concerning an 11 year old female with no relevant medical history reported who on 08-FEB-2007 was vaccinated intramuscularly in the right deltoid wit a 0.5 ml dose of Gardasil"(lot Gardasil (lot 654702/0011U). Concomitant therapy included METADATE. On approximately 18-FEB-2007 or 19-FEB-2007, the patient developed upper right arm pain. The patient was seen on 21-FEB-2007 and 02-MAR-2007 for the upper arm pain. The pain occurred on the whole outer portion of the upper arm. The patient has no fever. Office notes indicated that "normal flexion of the elbow without problems with bilateral strength. Normal anterior and posterior rotation of shoulder. Normal internal and external rotation of shoulder. Active abduction of only 90 degrees, stopping due to pain. Able to rotate full 180 degrees with passive range but crying due to tears. Diagnosis was arm pain without reduction of strength, secondary to HPV injection. "The patient was treated with ibuprofen 350mg every 6 hours for 4 to 5 days. The nurse practitioner reported that she assumed the patient recovered from the arm pain because the patient did not return for a follow-up visit scheduled on 08-MAR-2007. The nurse practitioner considered the patient''s upper arm pain an other important medical event as the patient''s pain lasted longer that the indicated time frame of 48 hours for this experience. Additional information has been requested.


Changed on 9/14/2017

274069 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Washington
Vaccinated:2007-02-08
Onset:2007-02-18
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Crying, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: METADATE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0703USA01160

Write-up:Information has been received from a medical assistant and a nurse practitioner concerning an 11 year old female with no relevant medical history reported who on 08-FEB-2007 was vaccinated intramuscularly in the right deltoid wit a 0.5 ml dose of Gardasil (lot 654702/0011U). Concomitant therapy included METADATE. On approximately 18-FEB-2007 or 19-FEB-2007, the patient developed upper right arm pain. The patient was seen on 21-FEB-2007 and 02-MAR-2007 for the upper arm pain. The pain occurred on the whole outer portion of the upper arm. The patient has no fever. Office notes indicated that "normal flexion of the elbow without problems with bilateral strength. Normal anterior and posterior rotation of shoulder. Normal internal and external rotation of shoulder. Active abduction of only 90 degrees, stopping due to pain. Able to rotate full 180 degrees with passive range but crying due to tears. Diagnosis was arm pain without reduction of strength, secondary to HPV injection. "The patient was treated with ibuprofen 350mg every 6 hours for 4 to 5 days. The nurse practitioner reported that she assumed the patient recovered from the arm pain because the patient did not return for a follow-up visit scheduled on 08-MAR-2007. The nurse practitioner considered the patient''s upper arm pain an other important medical event as the patient''s pain lasted longer that the indicated time frame of 48 hours for this experience. Additional information has been requested.


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