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This is VAERS ID 324904

Case Details

VAERS ID: 324904 (history)  
Form: Version 1.0  
Gender: Female  
Location: Unknown  
   Days after vaccination:0
Submitted: 2008-08-14
   Days after onset:379
Entered: 2008-08-18
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Immediate post-injection reaction, Injection site pain
SMQs:, Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: WAES0807USA03705

Write-up: Information has been received from a physician''s assistant concerning a female with no drug reactions/allergies, who in August 2007, was vaccinated intramuscularly with a first dose of GARDASIL (lot # not reported) 0.5 mL. There was no concomitant medication. In August 2007 after the GARDASIL was administered, the patient experienced immediate severe pain at the injection site of the left arm. Due to the pain, the patient was unable to participate in sports. The pain resolved in one week without requiring treatment. The patient contacted the physician''s office via phone. The patient has not received the second or third dose of GARDASIL. No further information was available. Immediate severe pain at the injection site was considered to be disabling. Additional information has been requested.

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