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This is VAERS ID 398593

Case Details

VAERS ID: 398593 (history)  
Age: 13.0  
Gender: Female  
Location: South Carolina  
Vaccinated:2009-08-26
Onset:2009-08-29
   Days after vaccination:3
Submitted: 2010-08-04
   Days after onset:340
Entered: 2010-09-08
   Days after submission:35
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Activities of daily living impaired, Arthralgia, Back pain, Fatigue, Injection site pain
SMQs:, Retroperitoneal fibrosis (broad), Dementia (broad), Extravasation events (injections, infusions and implants) (broad), Arthritis (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EPIDUO; BACTRIM
Current Illness: Skin disorder
Preexisting Conditions:
Diagnostic Lab Data: None
CDC Split Type: WAES0909USA00323

Write-up: Information has been received from a physician concerning a 15 year old female patient who on 26-AUG-2009 was vaccinated with the first dose of GARDASIL. On 29-AUG-2009 the patient experienced back pain, joint pain, generalized injection site pain, fatigue and knee pain. At the time of the report all the patient''s symptoms persisted. No laboratory tests were performed. The patient sought medical attention by a phone call. Follow up information was received from a Certified Medical Assistant. It was reported that the 13 year old patient with skin disorder and no known drug allergies on 26-AUG-2009 was vaccinated with a dose of GARDASIL (Lot # 0558U, valid for rotavirus vaccine live (human-bovine) vaccine); no other vaccines were administered on the same day. Concomitant therapy included BACTRIM and EPIDUO. There were no labs/diagnostic studies performed. The patient was treated symptomatically with rest, fluids, and OTC analgesics. The patient could not go to school due to her fatigue and received a physician''s note which excused her from school until 14-SEP-2009. Although the office had not seen or heard from this patient since 02-SEP-2009, the Certified Medical Assistant assumed the patient had recovered as no school absence extension was requested. Fatigue was considered to be disabling. No further information is available.


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