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From the 12/30/2006 release of VAERS data (an older release, current is 4/1/2021):

This is VAERS ID 268271

Case Details

VAERS ID: 268271 (history)  
Form: Version .0  
Age: 19.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:2006-11-09
Onset:2006-11-19
   Days after vaccination:10
Submitted: 2006-12-01
   Days after onset:12
Entered: 2006-12-05
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other       Purchased by: Unknown
Symptoms: Bacterial infection, Laboratory test abnormal, Myalgia, Rash, Skin discolouration
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Eosinophilic pneumonia (broad), Hypotonic-hyporesponsive episode (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zyrtec, Hormonal contraceptives.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Medical panel neg, trace hemoglobin 11/20/06, rapid streptococcus positive, WBC count elevated 11/20/06.
CDC Split Type:

Write-up: Information has been received from a physician concerning a 19 year old female with no pertinent medical history or drug reactions allergies, who on 11/9/06 was vaccinated at her OB/GYN''''s office with HPV vaccine. Concomitant therapy included Zyrtec and o"ral hormonal contraceptives (unspecified). On 11/19/06 the pt developed a rash on the injection site arm, but not at the injections site. On 11/19/06 the pt also experienced extreme myalgia in all four extremities and her hand was discolored (purple). On


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