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This is VAERS ID 276081

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276081
VAERS Form:
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-01-01
Onset:2007-01-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Areflexia, Gait disturbance, Muscular weakness, Incorrect route of drug administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as /"buttocks/") with a first dose of Gardasil. Conco"mitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of Gardasil was administered intramuscularly into the left leg (also reported as /"buttocks/"). The physician reported that /"a few days to a


Changed on 12/8/2009

276081 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-01-01 2007-03-01
Onset:2007-01-01 2007-03-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - LL / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Areflexia, Gait disturbance, Muscular weakness, Pain, Paraesthesia, Sensory disturbance, Sciatic nerve neuropathy, Similar reaction on previous exposure to drug, Incorrect route of drug administration

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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA01018

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as /"buttocks/") "buttocks") with a first dose of Gardasil. Conco"mitant GARDASIL. Concomitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of Gardasil GARDASIL was administered intramuscularly into the left leg (also reported as /"buttocks/"). "buttocks"). The physician reported that /"a "a few days to a week after each dose the patient developed a sciatic neuropathy". It was further reported that the neuropathy of the right leg had resolved completely over a few weeks (approximately January 2007 or February 2007). The neuropathy of the left leg had improved, but has not resolved. The physician noted that the patient was still having weakness in the left leg and loss of deep tendon reflex at the level of the left ankle. She also had sensory complaints and tingling when touched at the lateral distal lower extremity. The pain was improved however. The patient was reported to still have a limp. It was also reported that the patient was able to attend school but was unable to participate in physical activities due to the sciatic neuropathy. The physician felt that the patient''s experiences were disabling. Additional information has been requested.


Changed on 9/14/2011

276081 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-03-01
Onset:2007-03-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 LL / IM

Administered by: Other      Purchased by: Other
Symptoms: Areflexia, Drug administered at inappropriate site, Gait disturbance, Muscular weakness, Pain, Paraesthesia, Sensory disturbance, Sciatic nerve neuropathy, Similar reaction on previous exposure to drug, Incorrect route of drug administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA01018

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as "buttocks") with a first dose of GARDASIL. Concomitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of GARDASIL was administered intramuscularly into the left leg (also reported as "buttocks"). The physician reported that "a few days to a week after each dose the patient developed a sciatic neuropathy". It was further reported that the neuropathy of the right leg had resolved completely over a few weeks (approximately January 2007 or February 2007). The neuropathy of the left leg had improved, but has not resolved. The physician noted that the patient was still having weakness in the left leg and loss of deep tendon reflex at the level of the left ankle. She also had sensory complaints and tingling when touched at the lateral distal lower extremity. The pain was improved however. The patient was reported to still have a limp. It was also reported that the patient was able to attend school but was unable to participate in physical activities due to the sciatic neuropathy. The physician felt that the patient''s experiences were disabling. Additional information has been requested.


Changed on 6/14/2014

276081 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-03-01
Onset:2007-03-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 LL / IM

Administered by: Other      Purchased by: Other
Symptoms: Areflexia, Drug administered at inappropriate site, Gait disturbance, Muscular weakness, Pain, Paraesthesia, Sensory disturbance, Sciatic nerve neuropathy, Similar reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA01018

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as "buttocks") with a first dose of GARDASIL. Concomitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of GARDASIL was administered intramuscularly into the left leg (also reported as "buttocks"). The physician reported that "a few days to a week after each dose the patient developed a sciatic neuropathy". It was further reported that the neuropathy of the right leg had resolved completely over a few weeks (approximately January 2007 or February 2007). The neuropathy of the left leg had improved, but has not resolved. The physician noted that the patient was still having weakness in the left leg and loss of deep tendon reflex at the level of the left ankle. She also had sensory complaints and tingling when touched at the lateral distal lower extremity. The pain was improved however. The patient was reported to still have a limp. It was also reported that the patient was able to attend school but was unable to participate in physical activities due to the sciatic neuropathy. The physician felt that the patient''s experiences were disabling. Additional information has been requested.


Changed on 5/14/2017

276081 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-03-01
Onset:2007-03-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 LL / IM

Administered by: Other      Purchased by: Other
Symptoms: Areflexia, Drug administered at inappropriate site, Gait disturbance, Muscular weakness, Pain, Paraesthesia, Sensory disturbance, Sciatic nerve neuropathy, Similar reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA01018

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as "buttocks") with a first dose of GARDASIL. Concomitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of GARDASIL was administered intramuscularly into the left leg (also reported as "buttocks"). The physician reported that "a few days to a week after each dose the patient developed a sciatic neuropathy". It was further reported that the neuropathy of the right leg had resolved completely over a few weeks (approximately January 2007 or February 2007). The neuropathy of the left leg had improved, but has not resolved. The physician noted that the patient was still having weakness in the left leg and loss of deep tendon reflex at the level of the left ankle. She also had sensory complaints and tingling when touched at the lateral distal lower extremity. The pain was improved however. The patient was reported to still have a limp. It was also reported that the patient was able to attend school but was unable to participate in physical activities due to the sciatic neuropathy. The physician felt that the patient''s experiences were disabling. Additional information has been requested.


Changed on 9/14/2017

276081 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Florida
Vaccinated:2007-03-01
Onset:2007-03-01
Submitted:2007-04-11
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 LL / IM

Administered by: Other      Purchased by: Other
Symptoms: Areflexia, Drug administered at inappropriate site, Gait disturbance, Muscular weakness, Pain, Paraesthesia, Sensory disturbance, Sciatic nerve neuropathy, Similar reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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: amitriptyline hydrochloride,MAXALT(RIZATRIPTAN BENZOATE)
Current Illness: Migraine, Tension headache
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA01018

Write-up:Information has been received from a physician concerning a 15 year old female with migraines and tension headaches who in January 2007, was vaccinated intramuscularly into the right leg (also reported as "buttocks") with a first dose of GARDASIL. Concomitant therapy included amytripaline (manufacturer unknown and rizatriptan benzoate. In March 2007, a second dose of GARDASIL was administered intramuscularly into the left leg (also reported as "buttocks"). The physician reported that "a few days to a week after each dose the patient developed a sciatic neuropathy". It was further reported that the neuropathy of the right leg had resolved completely over a few weeks (approximately January 2007 or February 2007). The neuropathy of the left leg had improved, but has not resolved. The physician noted that the patient was still having weakness in the left leg and loss of deep tendon reflex at the level of the left ankle. She also had sensory complaints and tingling when touched at the lateral distal lower extremity. The pain was improved however. The patient was reported to still have a limp. It was also reported that the patient was able to attend school but was unable to participate in physical activities due to the sciatic neuropathy. The physician felt that the patient''s experiences were disabling. Additional information has been requested.


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