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This is VAERS ID 276806

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276806
VAERS Form:
Age:49.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Hypoventilation, Inappropriate schedule of drug administration, Somnolence

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: SYNTHROID; VALTREX; vitamin b (unspecified)
Current Illness:
Preexisting Conditions: Penicillin allergy; Sulfonamide allergy; Drug hypersensitivity; Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 49 year old female with penicillin allergy, sulfa allergy, ciprofloxacin hydrochloride (Cipro) allergy, erythromycin (E-Mycin) allergy and hypothyroidism who on 15-MAR-2007 was vaccinated"with Gardasil, IM. Concomitant therapy included Levaothyroxine Na (SYNTHROID), vitamin B (unspecified) and valacyclovir HC1 (VALTREX). On 15-MAR-2007, after receiving the first dose of Gardasil, the patient became drowsy and had trouble taking a deep brea


Changed on 12/8/2009

276806 Before After
VAERS Form:
Age:49.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Hypoventilation, Inappropriate schedule of drug administration, Somnolence

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: SYNTHROID; VALTREX; vitamin b (unspecified)
Current Illness:
Preexisting Conditions: Penicillin allergy; Sulfonamide allergy; Drug hypersensitivity; Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA03468

Write-up:Information has been received from a registered nurse concerning a 49 year old female with penicillin allergy, sulfa allergy, ciprofloxacin hydrochloride (Cipro) allergy, erythromycin (E-Mycin) allergy and hypothyroidism who on 15-MAR-2007 was vaccinated"with vaccinated with Gardasil, IM. Concomitant therapy included Levaothyroxine Na (SYNTHROID), vitamin B (unspecified) and valacyclovir HC1 (VALTREX). On 15-MAR-2007, after receiving the first dose of Gardasil, the patient became drowsy and had trouble taking a deep brea breath. The patient was not in distress. No treatment was provided. The patient called the physician back on 16-MAR-2007 and reported she was still having trouble taking a deep breath. Additional information has been requested.


Changed on 9/14/2017

276806 Before After
VAERS Form:(blank) 1
Age:49.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-15
Onset:2007-03-15
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypoventilation, Inappropriate schedule of drug administration, Somnolence

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: SYNTHROID; VALTREX; vitamin b (unspecified)
Current Illness:
Preexisting Conditions: Penicillin allergy; Sulfonamide allergy; Drug hypersensitivity; Hypothyroidism
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA03468

Write-up:Information has been received from a registered nurse concerning a 49 year old female with penicillin allergy, sulfa allergy, ciprofloxacin hydrochloride (Cipro) allergy, erythromycin (E-Mycin) allergy and hypothyroidism who on 15-MAR-2007 was vaccinated with Gardasil, IM. Concomitant therapy included Levaothyroxine Na (SYNTHROID), vitamin B (unspecified) and valacyclovir HC1 (VALTREX). On 15-MAR-2007, after receiving the first dose of Gardasil, the patient became drowsy and had trouble taking a deep breath. The patient was not in distress. No treatment was provided. The patient called the physician back on 16-MAR-2007 and reported she was still having trouble taking a deep breath. Additional information has been requested.


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