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This is VAERS ID 276662

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276662
VAERS Form:
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Metrorrhagia

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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therap"y included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medica


Changed on 12/8/2009

276662 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Metrorrhagia

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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA02330

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therap"y therapy included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medica medical attention. Additional information has been requested.


Changed on 3/2/2010

276662 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U 0962F / - 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Metrorrhagia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA02330

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therapy included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Follow up information received from a health professional stated that the dose of GARDASIL was from Lot # 654510/0962F, not lot # 654702/0011U as perviously reported. It was also reported that the patient recovered from the event on 15-Mar-2007. Additional information is not expected.


Changed on 6/14/2014

276662 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Metrorrhagia

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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA02330

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therapy included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Follow up information received from a health professional stated that the dose of GARDASIL was from Lot # 654510/0962F, not lot # 654702/0011U as perviously reported. It was also reported that the patient recovered from the event on 15-Mar-2007. Additional information is not expected.


Changed on 5/14/2017

276662 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Metrorrhagia

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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA02330

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therapy included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Follow up information received from a health professional stated that the dose of GARDASIL was from Lot # 654510/0962F, not lot # 654702/0011U as perviously reported. It was also reported that the patient recovered from the event on 15-Mar-2007. Additional information is not expected.


Changed on 9/14/2017

276662 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-03
Onset:2007-03-04
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Metrorrhagia

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: CYCLESSA
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA02330

Write-up:Information has been received from a health professional concerning a 24 year old female with a penicillin allergy who on 03-MAR-2007 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot#654702/0011U). Concomitant therapy included CYCLESSA. On 04-MAR-2007 post vaccination the patient started spotting, menstrual cycle. It was reported that the patient is not pregnant. At the time of this report the spotting, menstrual cycle persisted. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Follow up information received from a health professional stated that the dose of GARDASIL was from Lot # 654510/0962F, not lot # 654702/0011U as perviously reported. It was also reported that the patient recovered from the event on 15-Mar-2007. Additional information is not expected.


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