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This is VAERS ID 282911

Case Details

VAERS ID: 282911 (history)  
Form: Version 1.0  
Age: 19.0  
Gender: Female  
Location: Tennessee  
Vaccinated:2007-04-20
Onset:2007-04-25
   Days after vaccination:5
Submitted: 2007-06-26
   Days after onset:62
Entered: 2007-06-27
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / UNK UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Effusion, Fluid retention, Hypokinesia, Injected limb mobility decreased, Musculoskeletal pain, Nuclear magnetic resonance imaging abnormal
SMQs:, Rhabdomyolysis/myopathy (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypotonic-hyporesponsive episode (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: magnetic resonance 05/11/07 - 8 mm in diameter fluid filled sack underneath the deltoid
CDC Split Type: WAES0706USA02798

Write-up: Information has been received from a physical therapist concerning a 19 year old female with an allergy to "vicryl sutures" who on approximately 20-APR-2007 was vaccinated with a dose of Gardasil. On approximately 25-APR-2007, five days after vaccination, the patient developed shoulder pain on the side where the vaccination was given. She saw her pediatrician, and was referred to an orthopedic physician. Magnetic resonance imaging was performed and showed an 8 mm in diameter fluid filled sack underneath the deltoid. The patient can not use the arm due to the pain in her shoulder. The patient''s shoulder pain and fluid-filled sack underneath the deltoid have persisted. The physician considered the shoulder pain and fluid-filled sack underneath the deltoid to be disabling events. Additional information has been requested.


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