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This is VAERS ID 274704

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274704
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-02-14
Onset:2007-02-22
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Axillary pain, Axillary mass

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 17 year old female who on 14 Feb 2007 was vaccinated IM in the left deltoid with a 0.5mL dose of Gardasil vaccine. There was no concomitant medication. On 22 Feb 2007 the patient /"develop"ed a painful lump underneath the arm pit of the same injection arm/". The nurse reported that the patient was told to follow up with the physician as soon as possible. At the time of the report, the patient had not recovered. The patient sought unspecifie


Changed on 12/8/2009

274704 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-02-14
Onset:2007-02-22
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Axillary pain, Axillary mass

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA04326

Write-up:Information has been received from a registered nurse concerning a 17 year old female who on 14 Feb 2007 was vaccinated IM in the left deltoid with a 0.5mL dose of Gardasil vaccine. There was no concomitant medication. On 22 Feb 2007 the patient /"develop"ed "developed a painful lump underneath the arm pit of the same injection arm/". arm". The nurse reported that the patient was told to follow up with the physician as soon as possible. At the time of the report, the patient had not recovered. The patient sought unspecifie unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

274704 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-02-14
Onset:2007-02-22
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Axillary pain, Axillary mass

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA04326

Write-up:Information has been received from a registered nurse concerning a 17 year old female who on 14 Feb 2007 was vaccinated IM in the left deltoid with a 0.5mL dose of Gardasil vaccine. There was no concomitant medication. On 22 Feb 2007 the patient "developed a painful lump underneath the arm pit of the same injection arm". The nurse reported that the patient was told to follow up with the physician as soon as possible. At the time of the report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274704&WAYBACKHISTORY=ON


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