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This is VAERS ID 274071

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274071
VAERS Form:
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Dysphonia, Eye swelling, Nasal congestion, Swelling face, Laboratory test

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: diagnostic laboratory - respiratory panel
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female who on 05-MAR-2007 was vaccinated by injection with the first dose of Gardasil. It was reported that the patient experienced an adverse experienced 2 hours after receiving Gard"asil. The patient went to the emergency room with a swollen face and eyes, no fever reported. The patient received eye drops and BENADRYL. On 06-MAR-2007 the patient returned to the clinic with tender and a /"little puppy eyes/". On 07-MAR-2007 the patien


Changed on 12/8/2009

274071 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dysphonia, Eye swelling, Nasal congestion, Swelling face, Tenderness, Throat irritation, Laboratory test

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: diagnostic laboratory - respiratory panel
CDC 'Split Type': (blank) WAES0703USA01473

Write-up:Information has been received from a physician concerning a 17 year old female who on 05-MAR-2007 was vaccinated by injection with the first dose of Gardasil. It was reported that the patient experienced an adverse experienced 2 hours after receiving Gard"asil. Gardasil. The patient went to the emergency room with a swollen face and eyes, no fever reported. The patient received eye drops and BENADRYL. On 06-MAR-2007 the patient returned to the clinic with tender and a /"little "little puppy eyes/". eyes". On 07-MAR-2007 the patien patient had an itchy throat and her eyes were still tender. On 08-MAR-2007, the patient sounded "nasal". The pat6ient sought unspecified medical attention. The physician added an antibiotic and the patient was still taking diphenhydramine hydrochloride. The patient has a "respiratory panel". The physician reported that the patient will not continue the series. At the time of the report, it was unknown if the patient recovered. The physician considered swollen face and eyes, tender eyes, itchy throat, and sounded "nasal" to be other important medical events.


Changed on 9/14/2017

274071 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Dysphonia, Eye swelling, Nasal congestion, Swelling face, Tenderness, Throat irritation, Laboratory test

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: diagnostic laboratory - respiratory panel
CDC 'Split Type': WAES0703USA01473

Write-up:Information has been received from a physician concerning a 17 year old female who on 05-MAR-2007 was vaccinated by injection with the first dose of Gardasil. It was reported that the patient experienced an adverse experienced 2 hours after receiving Gardasil. The patient went to the emergency room with a swollen face and eyes, no fever reported. The patient received eye drops and BENADRYL. On 06-MAR-2007 the patient returned to the clinic with tender and a "little puppy eyes". On 07-MAR-2007 the patient had an itchy throat and her eyes were still tender. On 08-MAR-2007, the patient sounded "nasal". The pat6ient sought unspecified medical attention. The physician added an antibiotic and the patient was still taking diphenhydramine hydrochloride. The patient has a "respiratory panel". The physician reported that the patient will not continue the series. At the time of the report, it was unknown if the patient recovered. The physician considered swollen face and eyes, tender eyes, itchy throat, and sounded "nasal" to be other important medical events.


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