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This is VAERS ID 274722

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274722
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2006-11-28
Onset:2006-11-29
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Cardiac murmur
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 17 year old female with a cardiac murmur who on 28-NOV-2006 was vaccinated IM with her first dose of HPV, lot #654540/0800F. On 29-FEB-06 the patient experienced minor soreness arou"nd the injection site. The patient did not return for her 2nd dose until 27-FEB-2007. The patient recovered. Additional information has been requested.


Changed on 12/8/2009

274722 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2006-11-28
Onset:2006-11-29
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Inappropriate schedule of drug administration, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Cardiac murmur
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0702USA04640

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 17 year old female with a cardiac murmur who on 28-NOV-2006 was vaccinated IM with her first dose of HPV, lot #654540/0800F. On 29-FEB-06 the patient experienced minor soreness arou"nd around the injection site. The patient did not return for her 2nd dose until 27-FEB-2007. The patient recovered. Additional information has been requested.


Changed on 9/14/2017

274722 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New Mexico
Vaccinated:2006-11-28
Onset:2006-11-29
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Cardiac murmur
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA04640

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 17 year old female with a cardiac murmur who on 28-NOV-2006 was vaccinated IM with her first dose of HPV, lot #654540/0800F. On 29-FEB-06 the patient experienced minor soreness around the injection site. The patient did not return for her 2nd dose until 27-FEB-2007. The patient recovered. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274722&WAYBACKHISTORY=ON


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