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This is VAERS ID 635412

Case Details

VAERS ID: 635412 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: New York  
Vaccinated:2014-11-19
Onset:2014-11-25
   Days after vaccination:6
Submitted: 2016-05-12
   Days after onset:533
Entered: 2016-05-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT) / MEDIMMUNE VACCINES, INC. CJ2129 / 7+ NS / IN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K009482 / 1 LA / IM

Administered by: Private       Purchased by: Unknown
Symptoms: Arthralgia, Blood test, Nuclear magnetic resonance imaging, Pain, Spinal pain
SMQs:, Arthritis (broad)

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:
Current Illness: healthy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Extensive blood work; MRI to rule out meniscus tear prior to moving on to arthritis diagnosis
CDC Split Type:

Write-up: Being treated with methotrexate injections and no relief for 1 year. Pain is at a 9/10 daily and has spread to hips and spine.


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