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This is VAERS ID 276825

Case Details

VAERS ID: 276825 (history)  
Form: Version 1.0  
Age:   
Gender: Female  
Location: New York  
Vaccinated:2006-12-15
Onset:2007-01-15
   Days after vaccination:31
Submitted: 2007-04-13
   Days after onset:87
Entered: 2007-04-16
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other       Purchased by: Other
Symptoms: Antinuclear antibody positive, C-reactive protein normal, Hypoaesthesia, Nuclear magnetic resonance imaging normal, Pain, Pain in extremity
SMQs:, Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: magnetic resonance 01?/??/07 - Negative, serum C-reactive 01?/??/07 - negative, serum ANA 01?/??/07 - positive
CDC Split Type: WAES0703USA03739

Write-up: Information has been received from a physician concerning his daughter, a female patient, with a penicillin allergy, who on 15-DEC-2006 was vaccinated with the first dose, 0.5ml, IM, of Gardasil. There was no concomitant medication. On approximately 15-JAN-2007 (" one month later") the physician''s daughter experienced "numbness and pain in her right foot and leg." The physician reported that his daughter was examined by both a neurologist and a rheumatologist, and was not certain if she was "experiencing significant disability," but was waiting to see if the numbness and pain resolved. The physician reported there was "some improvement." Additional information has been requested. 01-Jan-2007 magnetic resonance imaging, Negative, 01-Jan-2007 serum C-reactive protein test, Negative, 01-Jan-2007 serum antinuclear antibodies test, Positive


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