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This is VAERS ID 382750

Case Details

VAERS ID: 382750 (history)  
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. - / 0 UN / IM

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

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
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.


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