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This is VAERS ID 275365

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275365
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Hypokinesia, Pain in extremity, X-ray normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: joint X-ray 01/15/07 negat
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an 18 year old female with AMOXIL allergy who on 15-JAN-2007 was vaccinated with the first dose of Gardasil (lot #655619/1427F), IM, 0.5 ml. Concomitant therapy included hormonal contraceptives (un"specified). On 15-JAN-2007, the patient experienced prolonged left arm pain and limitation of movement secondary to arm pain following the first dose of Gardasil. No redness or swelling was noted. A shoulder x-ray was negative. The patient was treated wit


Changed on 12/8/2009

275365 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - UN / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Hypokinesia, Pain in extremity, X-ray normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: joint X-ray 01/15/07 negat
CDC 'Split Type': (blank) WAES0703USA03948

Write-up:Information has been received from a physician concerning an 18 year old female with AMOXIL allergy who on 15-JAN-2007 was vaccinated with the first dose of Gardasil (lot #655619/1427F), IM, 0.5 ml. Concomitant therapy included hormonal contraceptives (un"specified). (unspecified). On 15-JAN-2007, the patient experienced prolonged left arm pain and limitation of movement secondary to arm pain following the first dose of Gardasil. No redness or swelling was noted. A shoulder x-ray was negative. The patient was treated wit with an unspecified NSAID''s (non-steroidal, anti-inflammatory drug) and was referred to a neurologist. At the time of the report, the patient''s prolonged left arm pain persisted and was considered to be disabling. Additional information has been requested.


Changed on 9/14/2017

275365 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-15
Onset:2007-01-15
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Hypokinesia, Pain in extremity, X-ray normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: joint X-ray 01/15/07 negat
CDC 'Split Type': WAES0703USA03948

Write-up:Information has been received from a physician concerning an 18 year old female with AMOXIL allergy who on 15-JAN-2007 was vaccinated with the first dose of Gardasil (lot #655619/1427F), IM, 0.5 ml. Concomitant therapy included hormonal contraceptives (unspecified). On 15-JAN-2007, the patient experienced prolonged left arm pain and limitation of movement secondary to arm pain following the first dose of Gardasil. No redness or swelling was noted. A shoulder x-ray was negative. The patient was treated with an unspecified NSAID''s (non-steroidal, anti-inflammatory drug) and was referred to a neurologist. At the time of the report, the patient''s prolonged left arm pain persisted and was considered to be disabling. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275365&WAYBACKHISTORY=ON


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