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This is VAERS ID 276161

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276161
VAERS Form:
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-01-03
Onset:2007-02-23
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a licensed practical nurse, concerning a 20 year old female patient, who on 03-JAN-2007 was vaccinated with the first dose, 0.5 ml, IM, of Gardasil (Lot # 654389/0961F). There was no concomitant medication. On approximat"ely 23-FEB-2007, the patient developed /"hives that started approximately 1 week before her appointment for the second dose (02-MAR-2007). The nurse added that the patient''''s /"primary physician gave her an analgesic/" (name unknown). The nurse stated tha


Changed on 12/8/2009

276161 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-01-03
Onset:2007-02-23
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA01048

Write-up:Information has been received from a licensed practical nurse, concerning a 20 year old female patient, who on 03-JAN-2007 was vaccinated with the first dose, 0.5 ml, IM, of Gardasil (Lot # 654389/0961F). There was no concomitant medication. On approximat"ely approximately 23-FEB-2007, the patient developed /"hives "hives that started approximately 1 week before her appointment for the second dose (02-MAR-2007). The nurse added that the patient''''s /"primary patient''s "primary physician gave her an analgesic/" analgesic" (name unknown). The nurse stated tha that the patient"still had the hives when she came to the office" for her appointment and reported "the hives were mostly on both arms." The patient "received the second dose" of Gardasil on 02-MAR-2007. Additional information has been requested.


Changed on 9/14/2017

276161 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-01-03
Onset:2007-02-23
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA01048

Write-up:Information has been received from a licensed practical nurse, concerning a 20 year old female patient, who on 03-JAN-2007 was vaccinated with the first dose, 0.5 ml, IM, of Gardasil (Lot # 654389/0961F). There was no concomitant medication. On approximately 23-FEB-2007, the patient developed "hives that started approximately 1 week before her appointment for the second dose (02-MAR-2007). The nurse added that the patient''s "primary physician gave her an analgesic" (name unknown). The nurse stated that the patient"still had the hives when she came to the office" for her appointment and reported "the hives were mostly on both arms." The patient "received the second dose" of Gardasil on 02-MAR-2007. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276161&WAYBACKHISTORY=ON


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