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This is VAERS ID 274736

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274736
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: vitamins (unspecified0
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # /"0604F/"). Conc"omitant therapy included vitamins (unspecified). Subsequently the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and /"felt feverish with chills./" Unspecifi


Changed on 12/8/2009

274736 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:0000-00-00
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified0
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA00109

Write-up:Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # /"0604F/"). Conc"omitant "0604F"). Concomitant therapy included vitamins (unspecified). Subsequently the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and /"felt "felt feverish with chills./" Unspecifi chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


Changed on 2/5/2010

274736 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:0000-00-00 2006-12-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified0
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00109

Write-up:Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). Subsequently the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


Changed on 3/2/2010

274736 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified0 (unspecified)
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00109

Write-up:This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). Subsequently On 18-DEC-2006 the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


Changed on 6/14/2014

274736 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00109

Write-up:This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). On 18-DEC-2006 the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


Changed on 5/14/2017

274736 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00109

Write-up:This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). On 18-DEC-2006 the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


Changed on 9/14/2017

274736 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:California
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Back pain, Chills, Dizziness, Injection site pain, Nausea, Pruritus, Pyrexia

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: vitamins (unspecified)
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00109

Write-up:This is in follow-up to report (s) previously submitted on 3/14/2007. Information has been received from a nurse practitioner concerning a 26 year old female with no pertinent medical history who on 18-DEC-2006 was vaccinated intramuscularly, into the left deltoid with a first 0.5 ml dose of Gardasil (lot # "0604F"). Concomitant therapy included vitamins (unspecified). On 18-DEC-2006 the patient experienced soreness at the injection site, sacral back pain, mild low abdominal cramping, nausea, generalized itchiness, mild dizziness and "felt feverish with chills." Unspecified medical attention was sought. There were no laboratory or diagnostic tests performed. The patient recovered in 1 week without treatment. Additional information has been requested.


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