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This is VAERS ID 276880

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276880
Age:11.0
Gender:Female
Location:Illinois
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dizziness, Lacrimation increased, Injected limb mobility decreased, Hot flush, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning an 11 year old female student who on 02-MAR-2007 at 11:50AM, was vaccinated IM into the left deltoid with a first dose of Gardasil (Lot# 654389/0961F). There was no illness at the time of va"ccination. On 02-MAR-2007, immediately post injection, the patient experienced acute pain bringing her to tears. The patient complained of hot flash surrounding her face, lightheadedness and stiff arm with difficulty raising her arm due to pain. The nurse


Changed on 12/8/2009

VAERS ID: 276880 Before After
Age:11.0
Gender:Female
Location:Illinois
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Dizziness, Lacrimation increased, Pain, Musculoskeletal stiffness, Injected limb mobility decreased, Hot flush, Immediate post-injection reaction

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA04433

Write-up:Information has been received from a registered nurse concerning an 11 year old female student who on 02-MAR-2007 at 11:50AM, was vaccinated IM into the left deltoid with a first dose of Gardasil (Lot# 654389/0961F). There was no illness at the time of va"ccination. vaccination. On 02-MAR-2007, immediately post injection, the patient experienced acute pain bringing her to tears. The patient complained of hot flash surrounding her face, lightheadedness and stiff arm with difficulty raising her arm due to pain. The nurse indicated that the symptoms subsided in five minutes except the pain continued. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276880&WAYBACKHISTORY=ON


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