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This is VAERS ID 272333

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272333
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-12
Onset:0000-00-00
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 12-DEC-2006 was vaccinated with her second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain down her arm one month after"receiving her second dose. The patient''''s pain down her arm persisted. Additional information has been requested.


Changed on 12/8/2009

272333 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-12
Onset:0000-00-00
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
CDC 'Split Type': (blank) WAES0701USA01933

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 12-DEC-2006 was vaccinated with her second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain down her arm one month after"receiving after receiving her second dose. The patient''''s patient''s pain down her arm persisted. Additional information has been requested.


Changed on 9/14/2017

272333 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-12
Onset:0000-00-00
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
CDC 'Split Type': WAES0701USA01933

Write-up:Information has been received from a registered nurse concerning a 13 year old female who on 12-DEC-2006 was vaccinated with her second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain down her arm one month after receiving her second dose. The patient''s pain down her arm persisted. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272333&WAYBACKHISTORY=ON


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