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This is VAERS ID 272504

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 272504
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-01-05
Onset:2007-01-06
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 UN / -

Administered by: Private      Purchased by: Unknown
Symptoms: Pain of skin, Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Unspecified congenital anomaly of heart; Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from an L.P.N. concerning a 13 year old female student with a congenital heart defect and allergy to contrast dye who on the morning of 05-JAN-2007 between approximately 9-11 a.m. was vaccinated in the left upper arm with her"second dose of Gardasil (yeast), lot#654389/0961F. In the p.m. of 06-JAN-2007 the patient developed skin tender and some skin /"bumps/" with pruritis X 2 days. It was reported that on 09-JAN-2007, the patient recovered. No further information is available


Changed on 12/8/2009

VAERS ID: 272504 Before After
Age:13.0
Gender:Female
Location:Florida
Vaccinated:2007-01-05
Onset:2007-01-06
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 UN / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Pain of skin, Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Unspecified congenital anomaly of heart; Hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA03895

Write-up:Information has been received from an L.P.N. concerning a 13 year old female student with a congenital heart defect and allergy to contrast dye who on the morning of 05-JAN-2007 between approximately 9-11 a.m. was vaccinated in the left upper arm with her"second her second dose of Gardasil (yeast), lot#654389/0961F. In the p.m. of 06-JAN-2007 the patient developed skin tender and some skin /"bumps/" "bumps" with pruritis X 2 days. It was reported that on 09-JAN-2007, the patient recovered. No further information is available available.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272504&WAYBACKHISTORY=ON


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