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This is VAERS ID 333630

Case Details

VAERS ID: 333630 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2008-11-05
Onset:2008-11-21
   Days after vaccination:16
Submitted: 2008-12-01
   Days after onset:10
Entered: 2008-12-02
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1486U / 2 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Arthralgia, Gait disturbance, Rash, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Hypersensitivity (narrow), Arthritis (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0811USA04010

Write-up: Information has been received from a physician concerning a 16 year old female patient who on 05-NOV-2008 was vaccinated with the second dose of GARDASIL (lot# 659655/1486U). Concomitant therapy included VARIVAX and ADACEL. On 21-NOV-2008 the patient developed rash, hives, urticaria and generalized joint pain in her knees, elbows and ankles, but she had no fever. The patient was instructed to take TYLENOL for the pain and she was referred to an urgent care physician who instructed the patient to take BENADRYL. On unspecified date lab tests were performed, but specifics are unspecified. As of 24-NOV-2008 the patient had not recovered. The physician considered the patient''s experience to be disabling because "it was hard for the patient to walk". Additional information has been requested.


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