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This is VAERS ID 272304

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272304
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-11-10
Onset:2006-11-10
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Bronchospasm, Cough

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

Write-up:Information has been received from a registered nurse concerning a 13 year old female with asthma and allergic eczema who on 10-NOV-2006 at 12:00PM, was vaccinated in the right arm intramuscularly with a first 0.5 ml dose of Gardasil (yeast) (lot#653978/0"955F). Concomitant suspect vaccination included a dose of tetanus toxoidon 10-NOV-2004. Other concomitant therapy included albuterol and ZYRTEC. There was no illness at the time of vaccination. On 10-Nov-2006 the patient experienced bronchospasm 20 minute


Changed on 12/8/2009

272304 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-11-10
Onset:2006-11-10
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Bronchospasm, Cough

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ZYRTEC, tetanus toxoid
Current Illness: Asthma, Allergic eczema
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA00990

Write-up:Information has been received from a registered nurse concerning a 13 year old female with asthma and allergic eczema who on 10-NOV-2006 at 12:00PM, was vaccinated in the right arm intramuscularly with a first 0.5 ml dose of Gardasil (yeast) (lot#653978/0"955F). (lot#653978/0955F). Concomitant suspect vaccination included a dose of tetanus toxoidon 10-NOV-2004. Other concomitant therapy included albuterol and ZYRTEC. There was no illness at the time of vaccination. On 10-Nov-2006 the patient experienced bronchospasm 20 minute minutes after receiving Gardasil (yeast). It was also reported that the patient developed a cough but she did not vomit. The patient used her albuterol inhaler and then rested and was recovered on the same day, 10-NOV-2006. No vomiting and no other anaphylaxis type reaction was noted. Additional information is not expected.


Changed on 9/14/2017

272304 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-11-10
Onset:2006-11-10
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Bronchospasm, Cough

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, ZYRTEC, tetanus toxoid
Current Illness: Asthma, Allergic eczema
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA00990

Write-up:Information has been received from a registered nurse concerning a 13 year old female with asthma and allergic eczema who on 10-NOV-2006 at 12:00PM, was vaccinated in the right arm intramuscularly with a first 0.5 ml dose of Gardasil (yeast) (lot#653978/0955F). Concomitant suspect vaccination included a dose of tetanus toxoidon 10-NOV-2004. Other concomitant therapy included albuterol and ZYRTEC. There was no illness at the time of vaccination. On 10-Nov-2006 the patient experienced bronchospasm 20 minutes after receiving Gardasil (yeast). It was also reported that the patient developed a cough but she did not vomit. The patient used her albuterol inhaler and then rested and was recovered on the same day, 10-NOV-2006. No vomiting and no other anaphylaxis type reaction was noted. Additional information is not expected.


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