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This is VAERS ID 276871

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276871
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Thrombosis

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

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a first dose of Gardasil vaccine (yeast). Subsequently, the patient developed blood clots in her legs. It was reported that the patient was treated by her"primary care physician. The patient''''s outcomes was unknown. Additional information has been requested.


Changed on 12/8/2009

276871 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Thrombosis

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA04240

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a first dose of Gardasil vaccine (yeast). Subsequently, the patient developed blood clots in her legs. It was reported that the patient was treated by her"primary her primary care physician. The patient''''s patient''s outcomes was unknown. Additional information has been requested.


Changed on 9/14/2017

276871 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:North Carolina
Vaccinated:0000-00-00
Onset:0000-00-00
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: Other      Purchased by: Other
Symptoms: Thrombosis

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA04240

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a first dose of Gardasil vaccine (yeast). Subsequently, the patient developed blood clots in her legs. It was reported that the patient was treated by her primary care physician. The patient''s outcomes was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276871&WAYBACKHISTORY=ON


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