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This is VAERS ID 274972

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274972
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-11
Onset:2007-01-11
Submitted:2007-03-27
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chest pain, Chest X-ray normal, Electrocardiogram normal, Fibrin D dimer normal

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: None
Current Illness: None
Preexisting Conditions: Allergy Penicillin
Allergies:
Diagnostic Lab Data: Chest Xray & EKG within normal limit, Dedimer normal
CDC 'Split Type':

Write-up:Pt received Gardasil vaccine 1/11/07 at 100PM - Developed c/o chest pain late evening & went to hospital ER. Pt brought this to our attention 3/12/07 when she was scheduled for her second vaccination - dose not given. No intervention other than Advil give"n in ER.


Changed on 12/8/2009

274972 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-11
Onset:2007-01-11
Submitted:2007-03-27
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Chest pain, Chest X-ray normal, Electrocardiogram normal, Fibrin D dimer normal

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: None
Current Illness: None
Preexisting Conditions: Allergy Penicillin
Allergies:
Diagnostic Lab Data: Chest Xray & EKG within normal limit, Dedimer normal
CDC 'Split Type':

Write-up:Pt received Gardasil vaccine 1/11/07 at 100PM - Developed c/o chest pain late evening & went to hospital ER. Pt brought this to our attention 3/12/07 when she was scheduled for her second vaccination - dose not given. No intervention other than Advil give"n given in ER.


Changed on 9/14/2017

274972 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-11
Onset:2007-01-11
Submitted:2007-03-27
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chest pain, Chest X-ray normal, Electrocardiogram normal, Fibrin D dimer normal

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: None
Current Illness: None
Preexisting Conditions: Allergy Penicillin
Allergies:
Diagnostic Lab Data: Chest Xray & EKG within normal limit, Dedimer normal
CDC 'Split Type':

Write-up:Pt received Gardasil vaccine 1/11/07 at 100PM - Developed c/o chest pain late evening & went to hospital ER. Pt brought this to our attention 3/12/07 when she was scheduled for her second vaccination - dose not given. No intervention other than Advil given in ER.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274972&WAYBACKHISTORY=ON


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