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This is VAERS ID 270965

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270965
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2007-01-04
Onset:2007-01-04
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature increased, Dyspnoea, Influenza, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 04-JAN-2007 was vaccinated with a first dose of Gardasil (yeast) (0.5 ml) (lot # 654510/0962F). Subsequently, on 04-JAN-2007, the patient was rushed to the emerge"ncy room with symptoms of body aches, breathing problems and a temperature of 103. The patient was released from the emergency room within 12 hours. The nurse reported that the emergency room physician believed that the above reaction was due to influenza


Changed on 12/8/2009

270965 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2007-01-04
Onset:2007-01-04
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Body temperature increased, Dyspnoea, Influenza, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA02133

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 04-JAN-2007 was vaccinated with a first dose of Gardasil (yeast) (0.5 ml) (lot # 654510/0962F). Subsequently, on 04-JAN-2007, the patient was rushed to the emerge"ncy emergency room with symptoms of body aches, breathing problems and a temperature of 103. The patient was released from the emergency room within 12 hours. The nurse reported that the emergency room physician believed that the above reaction was due to influenza influenza. The patient recovered. The reporter considered the patient''s experience to be disabling. Additional information has been requested.


Changed on 9/14/2017

270965 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New York
Vaccinated:2007-01-04
Onset:2007-01-04
Submitted:2007-01-22
Entered:2007-01-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Body temperature increased, Dyspnoea, Influenza, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA02133

Write-up:Information has been received from a registered nurse concerning a 19 year old female who on 04-JAN-2007 was vaccinated with a first dose of Gardasil (yeast) (0.5 ml) (lot # 654510/0962F). Subsequently, on 04-JAN-2007, the patient was rushed to the emergency room with symptoms of body aches, breathing problems and a temperature of 103. The patient was released from the emergency room within 12 hours. The nurse reported that the emergency room physician believed that the above reaction was due to influenza. The patient recovered. The reporter considered the patient''s experience to be disabling. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=270965&WAYBACKHISTORY=ON


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