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This is VAERS ID 284166

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

284166
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pelvic pain, Activities of daily living impaired

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: ultrasound
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

284166 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:0000-00-00 2007-05-01
Onset:0000-00-00 2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0384U / - 1 UN / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Pelvic pain, Activities of daily living impaired

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown Unknown; None
Allergies:
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.


Changed on 4/7/2010

284166 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Pelvic pain, Activities of daily living impaired, Ultrasound scan normal, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.


Changed on 6/14/2014

284166 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Pelvic pain, Activities of daily living impaired, Ultrasound scan normal, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.


Changed on 5/14/2017

284166 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Pelvic pain, Activities of daily living impaired, Ultrasound scan normal, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.


Changed on 9/14/2017

284166 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-01
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Pelvic pain, Activities of daily living impaired, Ultrasound scan normal, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Allergies:
Diagnostic Lab Data: ultrasound, pelvic ultrasound - normal
CDC 'Split Type': WAES0705USA03899

Write-up:Information has been received from a physician concerning a 14 year old female patient who was vaccinated with 0.5ml first and second dose of Gardasil. Subsequently, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. This happened with both the first and second shots. Unspecified medical attention was sought. Laboratory diagnostic studies included a sonogram. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a licensed visiting nurse concerning a 14 year old female student with no medical history or allergies, who on 01-MAY-2007, was vaccinated IM with a second 0.5ml dose of GARDASIL (Lot# 657617/0384U). On 01-MAY-2007, the patient experienced pelvic pain to the point where she couldn''t get out of bed in the morning the day after receiving the vaccine. The patient was seen at her primary physicians office. Laboratory diagnostic studies included a pelvic ultrasound which was normal. On 03-MAY-2007, the patient recovered. It was also reported that the patient experienced pelvic pain after the first dose of GARDASIL. No product quality complaint was involved. Additional information is not expected.


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