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This is VAERS ID 394405

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History of Changes from the VAERS Wayback Machine

First Appeared on 8/31/2010

VAERS ID: 394405
VAERS Form:
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 6/14/2014

VAERS ID: 394405 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 4/14/2017

VAERS ID: 394405 Before After
VAERS Form:
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 0 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 9/14/2017

VAERS ID: 394405 Before After
VAERS Form:(blank) 1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 0 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 2/14/2018

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 6/14/2018

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 8/14/2018

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 9/14/2018

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 10/14/2018

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 12/24/2020

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 12/30/2020

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 5/7/2021

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.


Changed on 5/14/2021

VAERS ID: 394405 Before After
VAERS Form:1
Age:11.0
Sex:Female
Location:Florida
Vaccinated:2010-03-25
Onset:2010-03-27
Submitted:2010-07-26
Entered:2010-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA088BC / 1 AR / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Diarrhoea, Flushing, Blood urine present, Headache, Lethargy, Myalgia, Nausea, Pyrexia, Vision blurred, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Concomitant medications were unknown.
Current Illness:
Preexisting Conditions: No concomitant vaccinations. Relevant medical history was unknown. The subject had not experienced adverse events following previous vaccinations.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0857520A

Write-up: This case was reported by a physician via sales representative and described the occurrence of muscle pain in a 12-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). On 25 March 2010 the subject received 1st dose of CERVARIX (.5 ml ,unknown, unknown arm). On 27 March 2010, 2 days after vaccination with CERVARIX, the subject experienced severe muscle pain, joint pain, vomiting, diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine. On 10 April 2010, the muscle pain, joint pain, vomiting diarrhea, facial flushing, fever, nausea, blurred vision, lethargy, headache and blood in urine were resolved. Follow-up information received from healthcare professional (the subject''s mother) on 13 May 2010: CERVARIX was administered intramuscularly. The events resolved on 11 April 2010 (previously reported as 10 April 2010). The immunisation series with CERVARIX was discontinued.

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