Information has been received from a physician concerning a teenage female athlete who received all three doses of Gardasil.  The patient received the first and last injections in the right arm and the second dose in the left arm.  The patient complained of soreness in her arm immediately after receiving the third dose.  Two weeks later, her arm was still sore.  The patient became progressively worse with hypersensitivity to touch.  The patient was seen in the office and was referred to an orthopedic doctor to check her shoulder.  The Orthopedic physician stated that the patient's shoulder was fine.  The physician reported no abnormalities on exam; no evidence for abscess or hematoma.  Some time has passed but the patient's arm is still sore.  The patient is now seeing a pain specialist.  The patient was given Medrol pack initially with some subjective relief.  The patient is now being treated with Lyrica (started 18-Jan-2008) for neuropathic pain.  Additional information has been requested. Information has been received forma physician concerning a 17 year old female athlete who received all three doses of HPV vaccine. The patient received the first and last injections in the right arm and the second dose in the left arm. Follow up information was received from the physician and had conflicting information regarding the location of the third dose. It was reported that on 21-Dec-2007 the patient was intramuscularly vaccinated in the left deltoid with her third dosee of HPV (Lot # 658558/1061U). The patient complained of soreness in her arm immediately after receiving the third dose. Two weeks later, her arm was still sore. The patient became progressively worse with hypersensitivity to touch. The patient was seen in the office and was referred to an orhtopedic doctor to check her shoulder. The orthopedic physician stated that the patient's shoulder was fine. The physician reported no abnormalities in exam; no evidence for abscess or hematoma. Some time has passed but the patient's arm is still sore. The patient is now seeing a pain specialist. The patient was given MEDROL pack initially with no subjective relief. The patient is now being treated with LYRICA (started 18-Jan-2008) for neurapthic pain and continue treatment. Additional information has been requested. This is in follow-up to report(s) previously submitted on 2/14/2008. 4/7/2008.  Information has been received from a physician concerning a 17 year old female athlete who received all three doses of GARDASIL.  The patient received the first and last injections in the right arm and the second dose in the left arm.  Follow up information was received from the physician and had conflicting information regarding the location of the third dose.  It was reported that on 21-DEC-2007 the patient was intramuscularly vaccinated in the left deltoid with her third dose of GARDASIL (lot # 658568/1061U).  The patient complained of soreness in her arm immediately after receiving the third dose.  Two weeks later, her arm was still sore.  The patient became progressively worse with hypersensitivity to touch.  The patient was seen in the office and was referred to an orthopedic doctor to check her shoulder.  The Orthopedic physician stated that the patient's shoulder  was fine.  The physician reported no abnormalities on exam:  no evidence for abscess or hematoma.  Some time has passed but the patient's arm still sore.  The patient is now  seeing a pain specialist.  The patient was given MEDROL pack initially with some subjective relief.  The patient is now bein treated with LYRICA (started 18-Jan-2008) for neuropathic pain and continues treatment.  Follow up information from the physician, indicated since the patient started therapy with LYRICA in January, she has had significant improvement in her arm pain.  The physician is planning to slowly taper the LYRICA and observe the patient. No further detalis were provided.  Additional information has been requested.