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This is VAERS ID 274210

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274210
VAERS Form:
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2007-01-03
Onset:2007-01-04
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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: Penicillin allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 14 year old female patient with possible allergy to penicillin and erythromycin who on 03-JAN-2007 was vaccinated with a first dose of Gardasil (yeast), lot # 653938/0954F. The patient was not on"any medication. On 04-JAN-2007 the patient developed hives. The patient was examined by the physician on 05-JAN-2007. The patient was reported as completely recovered by 06-JAN-2007. Additional information has been requested.


Changed on 12/8/2009

274210 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2007-01-03
Onset:2007-01-04
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Urticaria

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: Penicillin allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA01925

Write-up:Information has been received from a physician concerning a 14 year old female patient with possible allergy to penicillin and erythromycin who on 03-JAN-2007 was vaccinated with a first dose of Gardasil (yeast), lot # 653938/0954F. The patient was not on"any on any medication. On 04-JAN-2007 the patient developed hives. The patient was examined by the physician on 05-JAN-2007. The patient was reported as completely recovered by 06-JAN-2007. Additional information has been requested.


Changed on 9/14/2017

274210 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Florida
Vaccinated:2007-01-03
Onset:2007-01-04
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: Penicillin allergy; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA01925

Write-up:Information has been received from a physician concerning a 14 year old female patient with possible allergy to penicillin and erythromycin who on 03-JAN-2007 was vaccinated with a first dose of Gardasil (yeast), lot # 653938/0954F. The patient was not on any medication. On 04-JAN-2007 the patient developed hives. The patient was examined by the physician on 05-JAN-2007. The patient was reported as completely recovered by 06-JAN-2007. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274210&WAYBACKHISTORY=ON


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