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This is VAERS ID 276824

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276824
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
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. - / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Pyrexia, Vomiting

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

Write-up:Information has been received from a physician concerning a 13 year old female who on 15-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (Lot# not reported). Concomitant therapy included tetanus toxoid (manufacturer unknown). On 16"-MAR-2007 the patient called her physician office and reported that at an unspecified time on 15-MAR-2007 post vaccination she developed dizziness, vomiting and a fever (actual temperature not reported). Unspecified medical attention was sought. The patie


Changed on 12/8/2009

276824 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
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. - / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Pyrexia, Vomiting

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA03736

Write-up:Information has been received from a physician concerning a 13 year old female who on 15-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (Lot# not reported). Concomitant therapy included tetanus toxoid (manufacturer unknown). On 16"-MAR-2007 16-MAR-2007 the patient called her physician office and reported that at an unspecified time on 15-MAR-2007 post vaccination she developed dizziness, vomiting and a fever (actual temperature not reported). Unspecified medical attention was sought. The patie patient has not contacted the physician again.


Changed on 9/14/2017

276824 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Unknown
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. - / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Pyrexia, Vomiting

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA03736

Write-up:Information has been received from a physician concerning a 13 year old female who on 15-MAR-2007 was vaccinated intramuscularly with the first dose of Gardasil (Lot# not reported). Concomitant therapy included tetanus toxoid (manufacturer unknown). On 16-MAR-2007 the patient called her physician office and reported that at an unspecified time on 15-MAR-2007 post vaccination she developed dizziness, vomiting and a fever (actual temperature not reported). Unspecified medical attention was sought. The patient has not contacted the physician again.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276824&WAYBACKHISTORY=ON


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