National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 382750

Case Details

VAERS ID: 382750 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Foreign  
Vaccinated:2009-06-08
Onset:2009-06-29
   Days after vaccination:21
Submitted: 2010-03-15
   Days after onset:259
Entered: 2010-03-16
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Arthritis
SMQs:, Systemic lupus erythematosus (broad), Arthritis (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES1003USA01645

Write-up: Initial case was reported on 09-MAR-2010 by Health Authority (HA ref. DK-DKMA-20094639). It was reported that a 12-year-old female patient with no concurrent illness reported was vaccinated with the first dose GARDASIL (i.m., batch number and site of administration not reported) on 08-JUN-2009. No concomitant medicine was reported. It was reported that the patient developed intermitting episodes of arthritis in the large joints 3 weeks post vaccination. It was reported that each episode of arthritis lasted for 3-5 days and that the patient was symptom free for 1 week, before the symptoms returned. It was reported that the patient had not recovered. The patient''s arthritis was considered to be disabling by reporter. Other business partner numbers include E2010-0558. No further information is available.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=382750


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166