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This is VAERS ID 276829

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276829
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-19
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Menorrhagia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tuberculin purified protein derivative
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 13 year old female patient who on 15-MAR-2007 was vaccinated IM with a first dose of Gardasil, lot #654510/0962F. Concomitant therapy included Adacel, Menactra and tuberculin purified protein der"ivative. On 19-MAR-2007 the patient developed an off cycle additional menstrual cycle with a heavy flow. Unspecified medical attention was sought. The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 276829 Before After
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-19
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Menorrhagia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: tuberculin purified protein derivative
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC 'Split Type': (blank) WAES0703USA03790

Write-up:Information has been received from a physician concerning a 13 year old female patient who on 15-MAR-2007 was vaccinated IM with a first dose of Gardasil, lot #654510/0962F. Concomitant therapy included Adacel, Menactra and tuberculin purified protein der"ivative. derivative. On 19-MAR-2007 the patient developed an off cycle additional menstrual cycle with a heavy flow. Unspecified medical attention was sought. The patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 276829 Before After
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-19
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / - UN / UN

Administered by: Other Private      Purchased by: Other Public
Symptoms: Menorrhagia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes No
Hospitalized? No
Previous Vaccinations:
Other Medications: tuberculin purified protein derivative
Current Illness:
Preexisting Conditions: Unk Unknown
Diagnostic Lab Data: Unk Tuberculin purified protein derivative
CDC 'Split Type': WAES0703USA03790

Write-up:Information Initial and follow up information has been received from a physician and a health care professional concerning a 13 year old female patient who on 15-MAR-2007 at 04:30 PM was vaccinated IM with a first dose of Gardasil, GARDASIL vaccine, lot #654510/0962F. Concomitant therapy included Adacel, Menactra ADACEL, MENACTRA and tuberculin purified protein derivative. On 19-MAR-2007 the patient developed an off cycle additional menstrual cycle with a heavy flow. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Additional information has been requested.


Changed on 4/7/2010

VAERS ID: 276829 Before After
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-03-15
Onset:2007-03-19
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR - / - UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Menorrhagia, Tuberculin test

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unk Tuberculin purified protein derivative
CDC 'Split Type': WAES0703USA03790

Write-up:Initial and follow up information has been received from a physician and a health care professional concerning a 13 year old female patient who on 15-MAR-2007 at 04:30 PM was vaccinated IM with a first dose of GARDASIL vaccine, lot #654510/0962F. Concomitant therapy included ADACEL, MENACTRA and tuberculin purified protein derivative. On 19-MAR-2007 the patient developed an off cycle additional menstrual cycle with a heavy flow. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Additional information has been requested.


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