National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 273513

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID: 273513 (history)  
Form: Version .0  
Age: 17.0  
Sex: Female  
Location: New York  
   Days after vaccination:0
Submitted: 2007-03-06
   Days after onset:82
Entered: 2007-03-07
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other       Purchased by: Unknown
Symptoms: Back pain, Neck pain, Pain in extremity, Pain in jaw
SMQs:, Retroperitoneal fibrosis (broad), Osteonecrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness: Penicillin allergy
Preexisting Conditions: Drug rash
Diagnostic Lab Data: NONE
CDC Split Type:

Write-up: Information has been received from a physician concerning a 17 year old female patient with a history of rash after taking amoxicillin, who on 14-DEC-2006 was vaccinated with the first dose, 0.5 ml, in the right arm, of Gardasil. Concomitant therapy inclu"ded (ORTHO TRI-CYCLEN). In December 2006 (date not specified), the patient /"experienced pain at left angle of jaw, neck pain and mid back pain. /"The physician reported that the /"mother treated daughter with ibuprofen and within 36 hours symptoms improv

New Search

Link To This Search Result:

Copyright © 2020 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166