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This is VAERS ID 340833

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

340833
VAERS Form:
Age:15.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2009-02-26
Entered:2009-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Back pain, Headache, Activities of daily living impaired

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0902USA03735

Write-up:Information has been received from a physician concerning a 15 year old female with no medical history and drug allergies who, on an unspecified date, was vaccinated intramuscularly with her first 0.5 ml dose of GARDASIL. There was no concomitant medication. The patient had experienced hip pain, lower back pain and headache after receiving the first dose of GARDASIL. It was noted that she had experienced pain in both of her hips but the left side had more pain than the right. The pain in her hips had made it difficult for the patient to participate in her soccer games. The patient sought medical attention and was seen by physician. The lot numbers and dates of administration were unknown. At the time of reporting (20-FEB-2009) the patient was recovering. The reporter considered the adverse experiences to be disabling. Additional information has been requested.


Changed on 9/14/2017

340833 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Maine
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2009-02-26
Entered:2009-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Back pain, Headache, Activities of daily living impaired

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0902USA03735

Write-up:Information has been received from a physician concerning a 15 year old female with no medical history and drug allergies who, on an unspecified date, was vaccinated intramuscularly with her first 0.5 ml dose of GARDASIL. There was no concomitant medication. The patient had experienced hip pain, lower back pain and headache after receiving the first dose of GARDASIL. It was noted that she had experienced pain in both of her hips but the left side had more pain than the right. The pain in her hips had made it difficult for the patient to participate in her soccer games. The patient sought medical attention and was seen by physician. The lot numbers and dates of administration were unknown. At the time of reporting (20-FEB-2009) the patient was recovering. The reporter considered the adverse experiences to be disabling. Additional information has been requested.


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