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This is VAERS ID 283934

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283934
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site pain, Injected limb mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old female with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-NOV-2006 was vaccinated IM with the first dose of Gardasil. She received the second dose on 04-JAN-2007 and the third dose on 02-MAY-2007 (Lot# 653938/0954F). Concomitant therapy included "Quersatin". On 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the vaccination and had become more severe since that time. The patient was seen in the office on 09-MAY-2007. No inflammation or edema was noted at that time. No labs were performed. As of 10-MAY-2007, the patient had not recovered from the events. Additional information has been requested.


Changed on 2/5/2010

283934 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site pain, Injected limb mobility decreased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old white female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-NOV-2006 02-MAY-2007 was vaccinated IM with into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of Gardasil. She received the GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007 and the third dose on 02-MAY-2007 (Lot# 653938/0954F). 04-JAN-2007. Concomitant therapy included "Quersatin". "Queruatin". On 02-MAY-2007 02-MAy-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in the hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. As At the time of 10-MAY-2007, this report, the patient had recovered. Additional infortmation is not recovered from the events. Additional information has been requested. expected.


Changed on 3/2/2010

283934 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 UN LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old white female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-MAY-2007 was vaccinated IM into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007. Concomitant therapy included "Queruatin". On 02-MAy-2007 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. At the time of this report, the patient had recovered. Additional infortmation is not expected.


Changed on 4/7/2010

283934 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Pain in extremity, Sensory disturbance, Joint range of motion decreased, Impaired work ability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-MAY-2007 was vaccinated IM into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007. Concomitant therapy included "Queruatin". On 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. At the time of this report, the patient had recovered. Additional infortmation is not expected.


Changed on 6/14/2014

283934 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Pain in extremity, Sensory disturbance, Joint range of motion decreased, Impaired work ability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-MAY-2007 was vaccinated IM into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007. Concomitant therapy included "Queruatin". On 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. At the time of this report, the patient had recovered. Additional infortmation is not expected.


Changed on 5/14/2017

283934 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Pain in extremity, Sensory disturbance, Joint range of motion decreased, Impaired work ability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-MAY-2007 was vaccinated IM into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007. Concomitant therapy included "Queruatin". On 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. At the time of this report, the patient had recovered. Additional infortmation is not expected.


Changed on 9/14/2017

283934 Before After
VAERS Form:(blank) 1
Age:27.0
Gender:Female
Location:Florida
Vaccinated:2007-05-02
Onset:2007-05-02
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 2 3 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Pain in extremity, Sensory disturbance, Joint range of motion decreased, Impaired work ability

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: [therapy unspecified]
Current Illness: Sulfonamide allergy; Penicillin allergy; Drug hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02200

Write-up:Information has been received from a registered nurse concerning a 27 year old female mall carrier with sulfa, penicillin, amoxicillin, lidocaine and Ceclor allergies who on 02-MAY-2007 was vaccinated IM into the left deltoid a third dose of GARDISIL (lot # 653938/0954P). The patient received her first dose of GARDISIL on 02-NOV-2006 and her second dose on 04-JAN-2007. Concomitant therapy included "Queruatin". On 02-MAY-2007 the patient experienced prolonged injection site pain and decreased range of motion in her arm. The pain began on the day of the of vaccination and had become more severe since that time. The patient called the office on 08-MAY-2007 and complained of very sore arm and "clicking sound in arm" with no redness or swelling. The patient was seen in hte office on 09-MAY-2007. No inflammation or edema was noted at that time. It was noted that the patient had missed 3 days of work. No labs were performed. At the time of this report, the patient had recovered. Additional infortmation is not expected.


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