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This is VAERS ID 275779

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275779
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-28
Onset:2007-01-31
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Abortion spontaneous, Ultrasound scan, Drug exposure during pregnancy, Gynaecological examination, Laboratory test

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: Pregnancy NOS (LMP = 1/31/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 02/26/07, gynecological 02/26/07, ultrasound 02/26/07
CDC 'Split Type':

Write-up:Information has been received from a consumer and a licensed practical nurse, through the pregnancy registry, concerning a 23 year old female, who was vaccinated on 28-SEP-2006 with the first dose of Gardasil, and on 28-NOV-2006 with the second dose of Ga"rdasil (Lot # 653735/0688F). There was no concomitant medication. The nurse reported that on 26-FEB-2007 (consumer reported as 13-MAR-2007, /"some time after/"she received the second dose) the patient had a miscarriage. The date of the last LMP was approx


Changed on 12/8/2009

275779 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-28
Onset:2007-01-31
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abortion spontaneous, Ultrasound scan, Drug exposure during pregnancy, Gynaecological examination, Laboratory test

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: Pregnancy NOS (LMP = 1/31/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 02/26/07, gynecological 02/26/07, ultrasound 02/26/07
CDC 'Split Type': (blank) WAES0704USA00075

Write-up:Information has been received from a consumer and a licensed practical nurse, through the pregnancy registry, concerning a 23 year old female, who was vaccinated on 28-SEP-2006 with the first dose of Gardasil, and on 28-NOV-2006 with the second dose of Ga"rdasil Gardasil (Lot # 653735/0688F). There was no concomitant medication. The nurse reported that on 26-FEB-2007 (consumer reported as 13-MAR-2007, /"some "some time after/"she after"she received the second dose) the patient had a miscarriage. The date of the last LMP was approx approximately 31-JAN-2007 ("late January"). According to the consumer, lab diagnostic tests included "several blood tests, ultrasounds, vaginal probe" (results not provided). On 29-MAR-2007, the third dose of Gardasil (Lot # 654389/0961F) was administered to the patient, and the nurse reported the patient "was fine" at that visit. The miscarriage was considered to be an other important medical event. Additional information has been requested.


Changed on 9/14/2017

275779 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-28
Onset:2007-01-31
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Abortion spontaneous, Ultrasound scan, Drug exposure during pregnancy, Gynaecological examination, Laboratory test

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: Pregnancy NOS (LMP = 1/31/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 02/26/07, gynecological 02/26/07, ultrasound 02/26/07
CDC 'Split Type': WAES0704USA00075

Write-up:Information has been received from a consumer and a licensed practical nurse, through the pregnancy registry, concerning a 23 year old female, who was vaccinated on 28-SEP-2006 with the first dose of Gardasil, and on 28-NOV-2006 with the second dose of Gardasil (Lot # 653735/0688F). There was no concomitant medication. The nurse reported that on 26-FEB-2007 (consumer reported as 13-MAR-2007, "some time after"she received the second dose) the patient had a miscarriage. The date of the last LMP was approximately 31-JAN-2007 ("late January"). According to the consumer, lab diagnostic tests included "several blood tests, ultrasounds, vaginal probe" (results not provided). On 29-MAR-2007, the third dose of Gardasil (Lot # 654389/0961F) was administered to the patient, and the nurse reported the patient "was fine" at that visit. The miscarriage was considered to be an other important medical event. Additional information has been requested.


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