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This is VAERS ID 276833

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276833
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-01-23
Onset:2007-02-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature increased, Pyrexia, White blood cell count decreased, Vaccine positive rechallenge

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: body temp, 02/02/07, 103.F; body temp 103.F; WBC count; 02/22/07 3.8
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 15 year old female patient who on 23-JAN-2007 was vaccinated IM with a first dose of Gardasil, lot#654702/0011u. On an unspecified date, the patient received the second dose of Gardasil, lot #656"372/0243U. 10 days after the first injection (on 02-FEB-2007) the patient developed fever of 103F. She developed fever of 103F 6 days after her second dose of Gardasil. The patient recovered completely after the first dose and the status was unknown after


Changed on 12/8/2009

276833 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-01-23
Onset:2007-02-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Body temperature increased, Pyrexia, White blood cell count decreased, Vaccine positive rechallenge

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: body temp, 02/02/07, 103.F; body temp 103.F; WBC count; 02/22/07 3.8
CDC 'Split Type': (blank) WAES0703USA03870

Write-up:Information has been received from a physician concerning a 15 year old female patient who on 23-JAN-2007 was vaccinated IM with a first dose of Gardasil, lot#654702/0011u. On an unspecified date, the patient received the second dose of Gardasil, lot #656"372/0243U. #656372/0243U. 10 days after the first injection (on 02-FEB-2007) the patient developed fever of 103F. She developed fever of 103F 6 days after her second dose of Gardasil. The patient recovered completely after the first dose and the status was unknown after the second dose. Medical attention was sought. Additional information has been requested.


Changed on 6/14/2014

276833 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-01-23
Onset:2007-02-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Body temperature increased, Pyrexia, White blood cell count decreased, Vaccine positive rechallenge

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: body temp, 02/02/07, 103.F; body temp 103.F; WBC count; 02/22/07 3.8
CDC 'Split Type': WAES0703USA03870

Write-up:Information has been received from a physician concerning a 15 year old female patient who on 23-JAN-2007 was vaccinated IM with a first dose of Gardasil, lot#654702/0011u. On an unspecified date, the patient received the second dose of Gardasil, lot #656372/0243U. 10 days after the first injection (on 02-FEB-2007) the patient developed fever of 103F. She developed fever of 103F 6 days after her second dose of Gardasil. The patient recovered completely after the first dose and the status was unknown after the second dose. Medical attention was sought. Additional information has been requested.


Changed on 5/14/2017

276833 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-01-23
Onset:2007-02-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Body temperature increased, Pyrexia, White blood cell count decreased, Vaccine positive rechallenge

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: body temp, 02/02/07, 103.F; body temp 103.F; WBC count; 02/22/07 3.8
CDC 'Split Type': WAES0703USA03870

Write-up:Information has been received from a physician concerning a 15 year old female patient who on 23-JAN-2007 was vaccinated IM with a first dose of Gardasil, lot#654702/0011u. On an unspecified date, the patient received the second dose of Gardasil, lot #656372/0243U. 10 days after the first injection (on 02-FEB-2007) the patient developed fever of 103F. She developed fever of 103F 6 days after her second dose of Gardasil. The patient recovered completely after the first dose and the status was unknown after the second dose. Medical attention was sought. Additional information has been requested.


Changed on 9/14/2017

276833 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-01-23
Onset:2007-02-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Body temperature increased, Pyrexia, White blood cell count decreased, Vaccine positive rechallenge

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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: body temp, 02/02/07, 103.F; body temp 103.F; WBC count; 02/22/07 3.8
CDC 'Split Type': WAES0703USA03870

Write-up:Information has been received from a physician concerning a 15 year old female patient who on 23-JAN-2007 was vaccinated IM with a first dose of Gardasil, lot#654702/0011u. On an unspecified date, the patient received the second dose of Gardasil, lot #656372/0243U. 10 days after the first injection (on 02-FEB-2007) the patient developed fever of 103F. She developed fever of 103F 6 days after her second dose of Gardasil. The patient recovered completely after the first dose and the status was unknown after the second dose. Medical attention was sought. Additional information has been requested.


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