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This is VAERS ID 276641

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276641
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-16
Onset:2007-01-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 17 year old female patient who was vaccinated with Gardasil (lot# 655619/1427F) (0.5 ml), intramuscularly in the deltoid. Concomitant therapy included birth control pills. Subsequently t"he patient complained of heaviness and pain in left arm. The patient outcome was reported as recovered. No product quality complaint was involved.


Changed on 12/8/2009

276641 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-16
Onset:2007-01-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0702USA01030

Write-up:Information has been received from a nurse practitioner concerning a 17 year old female patient who was vaccinated with Gardasil (lot# 655619/1427F) (0.5 ml), intramuscularly in the deltoid. Concomitant therapy included birth control pills. Subsequently t"he the patient complained of heaviness and pain in left arm. The patient outcome was reported as recovered. No product quality complaint was involved.


Changed on 9/14/2017

276641 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-16
Onset:2007-01-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain in extremity, Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal contraceptives
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA01030

Write-up:Information has been received from a nurse practitioner concerning a 17 year old female patient who was vaccinated with Gardasil (lot# 655619/1427F) (0.5 ml), intramuscularly in the deltoid. Concomitant therapy included birth control pills. Subsequently the patient complained of heaviness and pain in left arm. The patient outcome was reported as recovered. No product quality complaint was involved.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276641&WAYBACKHISTORY=ON


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