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This is VAERS ID 276137

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276137
VAERS Form:
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-12-15
Onset:2006-12-15
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Paraesthesia, Vomiting, Injected limb mobility decreased

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: albuterol; hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 21 year old female patient with asthma who on 15-DEC-2006 was vaccinated IM in her right arm with a dose of Gardasil, lot #654389/0961F. Concomitant therapy included hormonal contra"ceptives (unspecified) and albuterol inhaler (unspecified). The patient has had difficulty lifting her right arm since she was immunized in that arm on 15-DEC-2006. The patient also experienced tingling in her arm, nausea, and vomiting after the injection


Changed on 12/8/2009

276137 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-12-15
Onset:2006-12-15
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Paraesthesia, Vomiting, Injected limb mobility decreased

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: albuterol; hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA00630

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 21 year old female patient with asthma who on 15-DEC-2006 was vaccinated IM in her right arm with a dose of Gardasil, lot #654389/0961F. Concomitant therapy included hormonal contra"ceptives contraceptives (unspecified) and albuterol inhaler (unspecified). The patient has had difficulty lifting her right arm since she was immunized in that arm on 15-DEC-2006. The patient also experienced tingling in her arm, nausea, and vomiting after the injection injection. The patient was treated with physical therapy. The patient had not recovered as of the report date. Additional information has been requested.


Changed on 9/14/2017

276137 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-12-15
Onset:2006-12-15
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - UNK RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Paraesthesia, Vomiting, Injected limb mobility decreased

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: albuterol; hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00630

Write-up:Information has been received from a Registered Nurse (R.N.) concerning a 21 year old female patient with asthma who on 15-DEC-2006 was vaccinated IM in her right arm with a dose of Gardasil, lot #654389/0961F. Concomitant therapy included hormonal contraceptives (unspecified) and albuterol inhaler (unspecified). The patient has had difficulty lifting her right arm since she was immunized in that arm on 15-DEC-2006. The patient also experienced tingling in her arm, nausea, and vomiting after the injection. The patient was treated with physical therapy. The patient had not recovered as of the report date. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276137&WAYBACKHISTORY=ON


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