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This is VAERS ID 274302

Case Details

VAERS ID: 274302 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Wisconsin  
   Days after vaccination:0
Submitted: 2007-03-14
   Days after onset:54
Entered: 2007-03-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 - / IM

Administered by: Private       Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Borrelia test negative, Fatigue, Full blood count normal, Influenza serology negative, Injection site pain, Microbiology test, Musculoskeletal pain, Red blood cell sedimentation rate normal, Rheumatoid factor negative, Streptococcus serology negative, X-ray limb normal, X-ray of pelvis and hip
SMQs:, Rhabdomyolysis/myopathy (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (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: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: diagnostic microbiology 01/18?/07 - normal strep test, Lyme disease assay 01/18?/07 - normal, serum creatine kinase 01/18?/07 - normal, serum influenza B virus 01/18?/07 - normal, serum rheumatoid factor 01/18?/07 - normal, serum influenza A virus 01/18?/07 - normal, serum ANA 01/18?/07 - normal, complete blood cell 01/18?/07 - normal pelvic x-ray, 02/07/07, normal pelvis and hips; joint x-ray, 02/07/07, normal; joint x-ray, 02/07/07, normal; erythrocyte, 01/18?/07, normal; erythrocyte, 02/07/07, 41 mm/HR high
CDC Split Type: WAES0702USA03560

Write-up: Information has been received from a registered nurse concerning a 12 year old female who on 18-JAN-2007 was vaccinated IM with a first dose of Gardasil. No other vaccinations were administered. On approximately 18-JAN-2007, the patient experienced soreness at injection site, fatigue, musculo-skeletal pain, and joint pain. The following laboratory tests were performed on the patient: complete blood cell (CBC) count; erythrocyte sedimentation rate (sed rate); rheumatoid factor (RF); antinuclear antibodies test (ANA); creatine kinase (CPK); "strep test"; influenza A and B; Lyme disease enzyme-linked immunosorbent assay. All lat test results were reported as normal. The patient was not prescribed any treatment. By 20-FEB-2007, the patient was fully recovered. Additional information is not expected. 07/06/07 This is in follow-up to report(s) previously submitted on 3/14/2007. Follow-up from a physician indicated that approximately 10-14 days after the patient was vaccinated, she developed shoulder, hip and ankle pains. On 07-FEB-2007, the patient had a shoulder x-ray, right knee x-ray, and hip x-ray. All were normal. On 07-Feb-2007, the patient''s ESR was 41. On 17-FEB-2007 the patient recovered from the shoulder, hip and ankle pain. Additional information is not expected.

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