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This is VAERS ID 272286

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272286
VAERS Form:
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-01-02
Onset:2007-01-02
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / SC

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site bruising, Injection site reaction, Injection site swelling, Incorrect route of drug administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from al licensed practical nurse concerning a 17 year old female with no pertinent medical history, who on 02-JAN-2007 was vaccinated with the first dose of Gardasil. There was no concomitant medication. The nurse reported th"at the patient received the vaccination via the subcutaneous route and on 02-JAN-2007, developed in injection site reaction. The reaction was described as being that of a swollen and bruised injections site on the patients shoulder. Unspecified medical at


Changed on 12/8/2009

272286 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-01-02
Onset:2007-01-02
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / SC

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site bruising, Injection site reaction, Injection site swelling, Incorrect route of drug administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA00601

Write-up:Information has been received from al licensed practical nurse concerning a 17 year old female with no pertinent medical history, who on 02-JAN-2007 was vaccinated with the first dose of Gardasil. There was no concomitant medication. The nurse reported th"at that the patient received the vaccination via the subcutaneous route and on 02-JAN-2007, developed in injection site reaction. The reaction was described as being that of a swollen and bruised injections site on the patients shoulder. Unspecified medical at attention was sought. The patient subsequently recovered on 03-JAN-2007.


Changed on 9/14/2017

272286 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-01-02
Onset:2007-01-02
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / SC

Administered by: Other      Purchased by: Other
Symptoms: Injection site bruising, Injection site reaction, Injection site swelling, Incorrect route of drug administration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA00601

Write-up:Information has been received from al licensed practical nurse concerning a 17 year old female with no pertinent medical history, who on 02-JAN-2007 was vaccinated with the first dose of Gardasil. There was no concomitant medication. The nurse reported that the patient received the vaccination via the subcutaneous route and on 02-JAN-2007, developed in injection site reaction. The reaction was described as being that of a swollen and bruised injections site on the patients shoulder. Unspecified medical attention was sought. The patient subsequently recovered on 03-JAN-2007.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272286&WAYBACKHISTORY=ON


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