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This is VAERS ID 272876

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272876
VAERS Form:
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-08
Onset:2007-02-08
Submitted:2007-02-09
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 00134 / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Burning sensation, Injection site erythema, Injection site pain, Injection site rash, Incorrect dose administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Ortho-tricyclen, Synthroid
Current Illness:
Preexisting Conditions: egg allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Patient received partial dose of vaccine in left deltoid due to defective syringe. Pt immediately complained of a burning sensation on her arm where the medication ran (down her arm) I cleansed her entire upper arm with alcohol-pt relieved little relief."The she stated it was sore at about a 2 inch radius from the injection site. Pt was discharged in mother''''s care to monitor her. Pt''''s mother was contacted around 10:00 am the next day-stated-evening of 02/08/07, pt had severe pain at site and gave 2 500m


Changed on 12/8/2009

272876 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-08
Onset:2007-02-08
Submitted:2007-02-09
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 00134 / - LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Burning sensation, Injection site erythema, Injection site pain, Injection site rash, Vaccination complication, Incorrect dose administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Ortho-tricyclen, Synthroid
Current Illness:
Preexisting Conditions: egg allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Patient received partial dose of vaccine in left deltoid due to defective syringe. Pt immediately complained of a burning sensation on her arm where the medication ran (down her arm) I cleansed her entire upper arm with alcohol-pt relieved little relief."The relief. The she stated it was sore at about a 2 inch radius from the injection site. Pt was discharged in mother''''s mother''s care to monitor her. Pt''''s Pt''s mother was contacted around 10:00 am the next day-stated-evening of 02/08/07, pt had severe pain at site and gave 2 500m 500mg doses of Acetaminophen to relieve pain. Mother stated site looked red and raised-similar to a bee sting reaction. She also stated it was gone upon waking and pt now only complaining of moderate site pain with little swelling and redness. Pt to return in 3 days for reevaluation.


Changed on 9/14/2017

272876 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-08
Onset:2007-02-08
Submitted:2007-02-09
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 00134 / - UNK LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Burning sensation, Injection site erythema, Injection site pain, Injection site rash, Vaccination complication, Incorrect dose administered

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Ortho-tricyclen, Synthroid
Current Illness:
Preexisting Conditions: egg allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Patient received partial dose of vaccine in left deltoid due to defective syringe. Pt immediately complained of a burning sensation on her arm where the medication ran (down her arm) I cleansed her entire upper arm with alcohol-pt relieved little relief. The she stated it was sore at about a 2 inch radius from the injection site. Pt was discharged in mother''s care to monitor her. Pt''s mother was contacted around 10:00 am the next day-stated-evening of 02/08/07, pt had severe pain at site and gave 2 500mg doses of Acetaminophen to relieve pain. Mother stated site looked red and raised-similar to a bee sting reaction. She also stated it was gone upon waking and pt now only complaining of moderate site pain with little swelling and redness. Pt to return in 3 days for reevaluation.


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