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This is VAERS ID 274302

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274302
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
CDC 'Split Type':

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 soren"ess 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


Changed on 12/8/2009

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
CDC 'Split Type': (blank) 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 soren"ess 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.


Changed on 2/5/2010

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1424F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
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.


Changed on 3/2/2010

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Other Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
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, 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.


Changed on 4/7/2010

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, X-ray of pelvis and hip, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative, X-ray limb normal, Borrelia test negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
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.


Changed on 8/31/2010

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, X-ray of pelvis and hip, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Borrelia burgdorferi serology negative, Streptococcus serology negative, Influenza serology negative, X-ray limb normal, Borrelia test negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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
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.


Changed on 1/4/2011

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, X-ray of pelvis and hip, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Borrelia burgdorferi serology negative, Streptococcus serology negative, Influenza serology negative, X-ray limb normal, Borrelia test negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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.


Changed on 6/14/2014

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, X-ray of pelvis and hip, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative, X-ray limb normal, Borrelia test negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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.


Changed on 5/14/2017

VAERS ID: 274302 Before After
Age:12.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthralgia, Blood creatine phosphokinase normal, Fatigue, Full blood count normal, Injection site pain, Musculoskeletal pain, X-ray of pelvis and hip, Rheumatoid factor negative, Red blood cell sedimentation rate normal, Microbiology test, Streptococcus serology negative, Influenza serology negative, X-ray limb normal, Borrelia test negative

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
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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