Margaret Quinn, DNP, CPNP

An adolescent presented with persistent upper-extremity pain, redness, and 
axillary swelling upon lifting weights.

Ms. K was an active teenager and honor-roll student who worked in a restaurant on weekends. Yet approximately one hour after receiving her third dose of the HPV vaccine, Gardasil, Ms. K was found unconscious. She was seen in the local ED. Following her discharge, Ms. K developed headache, photophobia, nausea and an unsteady gait.