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This is VAERS ID 359042

Case Details

VAERS ID: 359042 (history)  
Age: 16.0  
Gender: Female  
Location: Pennsylvania  
Submitted: 2009-09-30
Entered: 2009-10-01
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Complex regional pain syndrome

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 30 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0909USA04030

Write-up: Information has been received from a physician concerning a 16 or 17 years old female who was vaccinated with a dose of GARDASIL. Subsequently the patient experienced reflex sympathetic dystrophy within 1 day of administration of the vaccine. The patient was hospitalized for 1 month. The name of the hospital, dates of hospitalization, or patient specific information was not available. At the reporting time the patient had not recovered. Reflex sympathetic dystrophy was considered to be disabling. Additional information has been requested.

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