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This is VAERS ID 290186

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

290186
VAERS Form:
Age:
Gender:Female
Location:West Virginia
Vaccinated:2007-06-01
Onset:2007-06-01
Submitted:2007-09-07
Entered:2007-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 1 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site induration, Nuclear magnetic resonance imaging abnormal, Pain in extremity, Synovitis, No reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Magnetic resonance 08/05/2007 - of right humerus revealed, /"Synovitis of glenohumeral joint/"
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a female with no pertinent medical history who on 01-JUN-2007 was vaccinated intramuscularly in the right deltoid with a second dose of Gardasil (Lot #0210U). There was no illness at the tim"e of vaccination. The patient''''s mother reported the patient''''s arm had been sore since injection 01-JUN-2007 and the pain extended to the elbow. A small induration could be felt at the site. The patient was treated with ADVIL, gabapentin, LIDODERM patche


Changed on 12/8/2009

290186 Before After
VAERS Form:
Age:
Gender:Female
Location:West Virginia
Vaccinated:2007-06-01
Onset:2007-06-01
Submitted:2007-09-07
Entered:2007-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 1 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site induration, Nuclear magnetic resonance imaging abnormal, Pain in extremity, Synovitis, No reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No 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: Magnetic resonance 08/05/2007 - of right humerus revealed, /"Synovitis "Synovitis of glenohumeral joint/" joint"
CDC 'Split Type': (blank) WAES0708USA05339

Write-up:Information has been received from a registered nurse concerning a female with no pertinent medical history who on 01-JUN-2007 was vaccinated intramuscularly in the right deltoid with a second dose of Gardasil (Lot #0210U). There was no illness at the tim"e time of vaccination. The patient''''s patient''s mother reported the patient''''s patient''s arm had been sore since injection 01-JUN-2007 and the pain extended to the elbow. A small induration could be felt at the site. The patient was treated with ADVIL, gabapentin, LIDODERM patche patches, prednisone, and ice. On 06-JUL-2007 and 16-JUL-2007 the patient was seen in the physician''s office. On 05-AUG-2007 an magnetic resonance imaging (MRI) was performed on the right humerus findings of the proximal humerus are nonspecific and can be related to trauma, infection or neoplasm and should be correlated with clinical findings. There is synovitis of the Glenohumeral joint, which again could be reactive, post-traumatic, or infectious in etiology. On 30-AUG-2007, it was noted that the patient was doing "much better." It was reported that the patient had no problems with the first injection of Gardasil. It was reported that the patient''s sister had the Gardasil injections with no problems. The nurse considered the painful arm and injection site induration to be persistent and significant disabling events. Additional information has been requested.


Changed on 9/14/2017

290186 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:West Virginia
Vaccinated:2007-06-01
Onset:2007-06-01
Submitted:2007-09-07
Entered:2007-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 1 2 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site induration, Nuclear magnetic resonance imaging abnormal, Pain in extremity, Synovitis, No reaction on previous exposure to drug

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Magnetic resonance 08/05/2007 - of right humerus revealed, "Synovitis of glenohumeral joint"
CDC 'Split Type': WAES0708USA05339

Write-up:Information has been received from a registered nurse concerning a female with no pertinent medical history who on 01-JUN-2007 was vaccinated intramuscularly in the right deltoid with a second dose of Gardasil (Lot #0210U). There was no illness at the time of vaccination. The patient''s mother reported the patient''s arm had been sore since injection 01-JUN-2007 and the pain extended to the elbow. A small induration could be felt at the site. The patient was treated with ADVIL, gabapentin, LIDODERM patches, prednisone, and ice. On 06-JUL-2007 and 16-JUL-2007 the patient was seen in the physician''s office. On 05-AUG-2007 an magnetic resonance imaging (MRI) was performed on the right humerus findings of the proximal humerus are nonspecific and can be related to trauma, infection or neoplasm and should be correlated with clinical findings. There is synovitis of the Glenohumeral joint, which again could be reactive, post-traumatic, or infectious in etiology. On 30-AUG-2007, it was noted that the patient was doing "much better." It was reported that the patient had no problems with the first injection of Gardasil. It was reported that the patient''s sister had the Gardasil injections with no problems. The nurse considered the painful arm and injection site induration to be persistent and significant disabling events. Additional information has been requested.


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