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This is VAERS ID 274187

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274187
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-06
Onset:2007-02-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Erythema, Hypoaesthesia, Injection site pain, Local reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a 16 year old female with no medical history who on 06-FEB-2007 was vaccinated IM in to the right deltoid with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). There was no concomi"tant medication. On 06-FEB-2007 after vaccination the patient developed a local reaction. She experienced 30 seconds of dizziness. The local reaction started with pain at the injection site that radiated down her arm and her entire arm was red. After the


Changed on 12/8/2009

274187 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-06
Onset:2007-02-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Erythema, Hypoaesthesia, Injection site pain, Local reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA01096

Write-up:Information has been received from a health professional concerning a 16 year old female with no medical history who on 06-FEB-2007 was vaccinated IM in to the right deltoid with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). There was no concomi"tant concomitant medication. On 06-FEB-2007 after vaccination the patient developed a local reaction. She experienced 30 seconds of dizziness. The local reaction started with pain at the injection site that radiated down her arm and her entire arm was red. After the patient subsided the arm went numb and then the patient was fine. The entire episode lasted only 5 minutes and the patient seemed fully recovered. Additional information is not expected.


Changed on 9/14/2017

274187 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-06
Onset:2007-02-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Erythema, Hypoaesthesia, Injection site pain, Local reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA01096

Write-up:Information has been received from a health professional concerning a 16 year old female with no medical history who on 06-FEB-2007 was vaccinated IM in to the right deltoid with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). There was no concomitant medication. On 06-FEB-2007 after vaccination the patient developed a local reaction. She experienced 30 seconds of dizziness. The local reaction started with pain at the injection site that radiated down her arm and her entire arm was red. After the patient subsided the arm went numb and then the patient was fine. The entire episode lasted only 5 minutes and the patient seemed fully recovered. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274187&WAYBACKHISTORY=ON


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