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This is VAERS ID 274574

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274574
Age:19.0
Gender:Female
Location:Texas
Vaccinated:2006-12-21
Onset:2006-12-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Drug administered at inappropriate site, Pain in extremity

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin, Prozac
Current Illness:
Preexisting Conditions: Papanicolaou smear abnormal
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 19 year old female with a history of abnormal papanicolaou smear who on 21-DEC-2006 was vaccinated IM in left deltoid with her first dose of HPV, lot # 653736/0689F. Concomitant the"rapy included Yasmin and Prozac. She experienced severe pain in the arm with the first dose. This reaction was reported at the time of her second vaccination. On 21-FEB-2006 her second dose of HPV, lot # 655617/1447 was administered via gluteus. No sympto


Changed on 12/8/2009

VAERS ID: 274574 Before After
Age:19.0
Gender:Female
Location:Texas
Vaccinated:2006-12-21
Onset:2006-12-21
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Drug administered at inappropriate site, Pain in extremity

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Yasmin, Prozac
Current Illness:
Preexisting Conditions: Papanicolaou smear abnormal
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA03916

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 19 year old female with a history of abnormal papanicolaou smear who on 21-DEC-2006 was vaccinated IM in left deltoid with her first dose of HPV, lot # 653736/0689F. Concomitant the"rapy therapy included Yasmin and Prozac. She experienced severe pain in the arm with the first dose. This reaction was reported at the time of her second vaccination. On 21-FEB-2006 her second dose of HPV, lot # 655617/1447 was administered via gluteus. No sympto symptoms were reported at that time. The patient was reported as recovered on an unspecified date. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274574&WAYBACKHISTORY=ON


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