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This is VAERS ID 457894

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2012

457894
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-06-21
Entered:2012-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Joint swelling, Pain, Contusion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALESSE-28
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1206USA01567

Write-up:Information has been received from an agency (Ref No. 000396733) concerning a 13 year old female patient who on unspecified date was vaccinated with a 0.5 mL dose of GARDASIL (Lot/batch number not reported) given intramuscularly. Concomitant therapy included ALESSE-28. Subsequently on unspecified date, the patient experienced contusion, joint swelling and pain. At the time of the report the patient had not recovered. The agency felt that contusion, joint swelling and pain were related to therapy with GARDASIL and were considered to be disabling. This was originally reported by a pharmacist. Additional information has been requested.


Changed on 6/14/2014

457894 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-06-21
Entered:2012-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Joint swelling, Pain, Contusion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALESSE-28
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1206USA01567

Write-up:Information has been received from an agency (Ref No. 000396733) concerning a 13 year old female patient who on unspecified date was vaccinated with a 0.5 mL dose of GARDASIL (Lot/batch number not reported) given intramuscularly. Concomitant therapy included ALESSE-28. Subsequently on unspecified date, the patient experienced contusion, joint swelling and pain. At the time of the report the patient had not recovered. The agency felt that contusion, joint swelling and pain were related to therapy with GARDASIL and were considered to be disabling. This was originally reported by a pharmacist. Additional information has been requested.


Changed on 4/14/2017

457894 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-06-21
Entered:2012-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Joint swelling, Pain, Contusion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALESSE-28
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1206USA01567

Write-up:Information has been received from an agency (Ref No. 000396733) concerning a 13 year old female patient who on unspecified date was vaccinated with a 0.5 mL dose of GARDASIL (Lot/batch number not reported) given intramuscularly. Concomitant therapy included ALESSE-28. Subsequently on unspecified date, the patient experienced contusion, joint swelling and pain. At the time of the report the patient had not recovered. The agency felt that contusion, joint swelling and pain were related to therapy with GARDASIL and were considered to be disabling. This was originally reported by a pharmacist. Additional information has been requested.


Changed on 9/14/2017

457894 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Foreign
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2012-06-21
Entered:2012-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Joint swelling, Pain, Contusion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ALESSE-28
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES1206USA01567

Write-up:Information has been received from an agency (Ref No. 000396733) concerning a 13 year old female patient who on unspecified date was vaccinated with a 0.5 mL dose of GARDASIL (Lot/batch number not reported) given intramuscularly. Concomitant therapy included ALESSE-28. Subsequently on unspecified date, the patient experienced contusion, joint swelling and pain. At the time of the report the patient had not recovered. The agency felt that contusion, joint swelling and pain were related to therapy with GARDASIL and were considered to be disabling. This was originally reported by a pharmacist. Additional information has been requested.


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