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This is VAERS ID 284624

Case Details

VAERS ID: 284624 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-06-05
Onset:2007-06-07
   Days after vaccination:2
Submitted: 2007-07-12
   Days after onset:35
Entered: 2007-07-13
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Tic
SMQs:, Dyskinesia (broad), Dystonia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: ADHD
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: Simple motor tic- shrugging shoulder, persistent x 1 month, 1st noted approximately 2d after Gardasil vaccine.


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