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This is VAERS ID 274122

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274122
VAERS Form:
Age:12.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Body temperature increased, Dizziness, Myalgia, Rash

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:
Current Illness: Aortic incompetence, Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Initial and follow up information has been received from an LPN and the mother of a 12 year old female patient with aortic insufficiency and migraine headaches who on 01-FEB-2007 was vaccinated IM with her first dose of Gardasil, lot #654741/0013U. There"was no concomitant medication. Subsequently, the patient experienced dizziness and developed an elevated temperature. It was also reported that the patient felt weak and had muscle aches for several days. The side effects eventually disappeared. However o


Changed on 12/8/2009

274122 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Body temperature increased, Dizziness, Myalgia, Rash

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:
Current Illness: Aortic incompetence, Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA00724

Write-up:Initial and follow up information has been received from an LPN and the mother of a 12 year old female patient with aortic insufficiency and migraine headaches who on 01-FEB-2007 was vaccinated IM with her first dose of Gardasil, lot #654741/0013U. There"was There was no concomitant medication. Subsequently, the patient experienced dizziness and developed an elevated temperature. It was also reported that the patient felt weak and had muscle aches for several days. The side effects eventually disappeared. However o on 21-FEB-2007, the patient woke up with breast rashes. As of 21-FEB-2007 breast rashes persisted. Additional information has been requested.


Changed on 9/14/2017

274122 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Body temperature increased, Dizziness, Myalgia, Rash

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:
Current Illness: Aortic incompetence, Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA00724

Write-up:Initial and follow up information has been received from an LPN and the mother of a 12 year old female patient with aortic insufficiency and migraine headaches who on 01-FEB-2007 was vaccinated IM with her first dose of Gardasil, lot #654741/0013U. There was no concomitant medication. Subsequently, the patient experienced dizziness and developed an elevated temperature. It was also reported that the patient felt weak and had muscle aches for several days. The side effects eventually disappeared. However on 21-FEB-2007, the patient woke up with breast rashes. As of 21-FEB-2007 breast rashes persisted. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274122&WAYBACKHISTORY=ON


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