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This is VAERS ID 274230

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274230
VAERS Form:
Age:12.0
Gender:Unknown
Location:Unknown
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Fatigue, Nausea, Urticaria, Wheezing

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from registered nurse supervisor, via a company representative, concerning a 12 year old patient who on 13-FEB-2007 was vaccinated IM in the left deltoid a 5:00 pm with the first dose of Gardasil. Three hours later (8:00pm),"the patient had developed hives on the face, back and bottom. By 8:30pm, the patient began to experience wheezing, but then /"slept fine through the night/". Treatment was not specified. The next morning (14-FEB-2007), hives /"had subsided,/" but the pati


Changed on 12/8/2009

274230 Before After
VAERS Form:
Age:12.0
Gender:Unknown
Location:Unknown
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Fatigue, Nausea, Urticaria, Wheezing

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA02913

Write-up:Information has been received from registered nurse supervisor, via a company representative, concerning a 12 year old patient who on 13-FEB-2007 was vaccinated IM in the left deltoid a 5:00 pm with the first dose of Gardasil. Three hours later (8:00pm),"the (8:00pm), the patient had developed hives on the face, back and bottom. By 8:30pm, the patient began to experience wheezing, but then /"slept "slept fine through the night/". night". Treatment was not specified. The next morning (14-FEB-2007), hives /"had subsided,/" "had subsided," but the pati patient "felt nauseous and tired." At the time of this report, the patient had not recovered. The nurse also reported that the patient will not be given the second and third dose of the vaccine. Additional information has been requested.


Changed on 9/14/2017

274230 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Unknown
Location:Unknown
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Fatigue, Nausea, Urticaria, Wheezing

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0702USA02913

Write-up:Information has been received from registered nurse supervisor, via a company representative, concerning a 12 year old patient who on 13-FEB-2007 was vaccinated IM in the left deltoid a 5:00 pm with the first dose of Gardasil. Three hours later (8:00pm), the patient had developed hives on the face, back and bottom. By 8:30pm, the patient began to experience wheezing, but then "slept fine through the night". Treatment was not specified. The next morning (14-FEB-2007), hives "had subsided," but the patient "felt nauseous and tired." At the time of this report, the patient had not recovered. The nurse also reported that the patient will not be given the second and third dose of the vaccine. Additional information has been requested.


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