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This is VAERS ID 283776

Case Details

VAERS ID: 283776 (history)  
Age: 21.0  
Gender: Female  
Location: Unknown  
Submitted: 2007-06-14
Entered: 2007-06-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Back pain, Injected limb mobility decreased, Pain in extremity
SMQs:, Retroperitoneal fibrosis (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES0705USA01287

Write-up: Information has been received concerning a 21 year old female with penicillin allergy who was vaccinated with Gardasil. Concomitant therapy included hormonal contraceptives (unspecified). Subsequently the patient experienced pain in the arm she was administered Gardasil. The pain radiated up her shoulder an into her back. She was not able to lift her arm without pain. She tried using a heating pad and an ice pack but neither helped. Additional information has been requested.

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