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This is VAERS ID 276156

Case Details

VAERS ID: 276156 (history)  
Form: Version 1.0  
Age: 37.0  
Gender: Female  
Location: California  
Vaccinated:2007-02-01
Onset:2007-02-01
   Days after vaccination:0
Submitted: 2007-04-06
   Days after onset:63
Entered: 2007-04-09
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 2 LA / UN

Administered by: Other       Purchased by: Other
Symptoms: Neck mass, Neck pain, Pain in extremity
SMQs:, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0703USA00980

Write-up: Information has been received from a physician concerning a female who on 30, Jan 2007, was vaccinated with GARDASIL. Subsequently, the patient developed a large lump on her neck and swelling to her thigh at injection site after immunization with GARDASIL. Unspecified medical attention was sought. As of 03, Mar 2007, the patient''s large lump on her neck and swelling to her thigh at injection site persisted. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/6/2007. Initial and follow up information has been received from a physician, concerning a 37 year old female patient, who at 1:30pm on 01-FEB-2007 (previously reported as 30-JAN-2007) was vaccinated in the left deltoid (previously reported as the thigh) with the second dose of GARDASIL vaccine (Lot #655617/1447F). On approximately 01-MAR-2007 ("onset at one month"), the patient developed a large lump on her neck and complained of pain in her neck and left arm (previously reported as swelling on the thigh). On 06-MAR-2007, the patient revisited the office, still complaining of pain, and was diagnosed with neck and left arm pain. The physician confirmed that the patient had recovered from the events on 10-MAR-2007. No further information is expected.


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