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This is VAERS ID 276649

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276649
VAERS Form:
Age:26.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-15
Onset:2007-02-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655503/0012U / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Pyrexia

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: Unknown
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 26 year old female who on 15-FEB-2007 was vaccinated with the first dose of Gardasil (yeast) (lot# 655503/0012U). On approximately 22-February-2007, /"approximately one week after vaccin"ation/", the patient developed a 10 cm. firm, red area at the injection site, and a low grade fever. The patient was scheduled to be seen by a health care provider on 12-MAR-2007. At the time of this report, the outcome of the events was unknown. Addition


Changed on 12/8/2009

VAERS ID: 276649 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-15
Onset:2007-02-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655503/0012U / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site induration, Pyrexia

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA01567

Write-up: Information has been received from a nurse practitioner concerning a 26 year old female who on 15-FEB-2007 was vaccinated with the first dose of Gardasil (yeast) (lot# 655503/0012U). On approximately 22-February-2007, /"approximately "approximately one week after vaccin"ation/", vaccination", the patient developed a 10 cm. firm, red area at the injection site, and a low grade fever. The patient was scheduled to be seen by a health care provider on 12-MAR-2007. At the time of this report, the outcome of the events was unknown. Addition Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 276649 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-15
Onset:2007-02-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655503/0012U / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Pyrexia

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01567

Write-up: Information has been received from a nurse practitioner concerning a 26 year old female who on 15-FEB-2007 was vaccinated with the first dose of Gardasil (yeast) (lot# 655503/0012U). On approximately 22-February-2007, "approximately one week after vaccination", the patient developed a 10 cm. firm, red area at the injection site, and a low grade fever. The patient was scheduled to be seen by a health care provider on 12-MAR-2007. At the time of this report, the outcome of the events was unknown. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 276649 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-02-15
Onset:2007-02-22
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 655503/0012U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Pyrexia

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01567

Write-up: Information has been received from a nurse practitioner concerning a 26 year old female who on 15-FEB-2007 was vaccinated with the first dose of Gardasil (yeast) (lot# 655503/0012U). On approximately 22-February-2007, "approximately one week after vaccination", the patient developed a 10 cm. firm, red area at the injection site, and a low grade fever. The patient was scheduled to be seen by a health care provider on 12-MAR-2007. At the time of this report, the outcome of the events was unknown. Additional information has been requested.


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