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This is VAERS ID 276844

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276844
VAERS Form:
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain, Pruritus, Pyrexia, Urticaria

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: (therapy unspecified)
Current Illness: Acne
Preexisting Conditions: Urticaria
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a certified medical assistant assistant and a physician concerning a female with acne and a history of urticaria (2004 unknown cause) who in February 2007 (/"about 3 weeks ago/"), was vaccinated IM with Gardasil. Concomi"tant therapy included unspecified antibiotic. Within a week the patient experienced urticaria, itchiness, low grade fever (100 F) and soreness. Subsequently, the patient recovered from urticaria, itchiness, low grade fever 100f and soreness. The patient s


Changed on 12/8/2009

276844 Before After
VAERS Form:
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain, Pruritus, Pyrexia, Urticaria

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: (therapy unspecified)
Current Illness: Acne
Preexisting Conditions: Urticaria
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA03976

Write-up:Information has been received from a certified medical assistant assistant and a physician concerning a female with acne and a history of urticaria (2004 unknown cause) who in February 2007 (/"about ("about 3 weeks ago/"), ago"), was vaccinated IM with Gardasil. Concomi"tant Concomitant therapy included unspecified antibiotic. Within a week the patient experienced urticaria, itchiness, low grade fever (100 F) and soreness. Subsequently, the patient recovered from urticaria, itchiness, low grade fever 100f and soreness. The patient s sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

276844 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Pain, Pruritus, Pyrexia, Urticaria

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: (therapy unspecified)
Current Illness: Acne
Preexisting Conditions: Urticaria
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03976

Write-up:Information has been received from a certified medical assistant assistant and a physician concerning a female with acne and a history of urticaria (2004 unknown cause) who in February 2007 ("about 3 weeks ago"), was vaccinated IM with Gardasil. Concomitant therapy included unspecified antibiotic. Within a week the patient experienced urticaria, itchiness, low grade fever (100 F) and soreness. Subsequently, the patient recovered from urticaria, itchiness, low grade fever 100f and soreness. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276844&WAYBACKHISTORY=ON


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