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This is VAERS ID 276885

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276885
VAERS Form:
Age:
Gender:Female
Location:Kentucky
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Arthralgia, Petechiae

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 physician concerning a female who was under 18 years old who on 20-MAR-2007 was vaccinated IM with her second dose of Gardasil. On 20-MAR-2007, within 12 hours after vaccination the patient experienced joint achiness."On 22-MAR-2007, the patient sought medical attention and the Nurse practitioner reported that the patient experienced /"petikia/" on her face and a red bump on the white of her one eye. Nurse Practitioner reported that the patient had no reaction to her 1


Changed on 12/8/2009

276885 Before After
VAERS Form:
Age:
Gender:Female
Location:Kentucky
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthralgia, Petechiae

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) WAES0703USA04554

Write-up:Information has been received from a physician concerning a female who was under 18 years old who on 20-MAR-2007 was vaccinated IM with her second dose of Gardasil. On 20-MAR-2007, within 12 hours after vaccination the patient experienced joint achiness."On achiness. On 22-MAR-2007, the patient sought medical attention and the Nurse practitioner reported that the patient experienced /"petikia/" "petikia" on her face and a red bump on the white of her one eye. Nurse Practitioner reported that the patient had no reaction to her 1 1st dose of Gardasil, but they are not planning to vaccinate the patient with the 3rd dose at this time. No further information is available.


Changed on 9/14/2017

276885 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Kentucky
Vaccinated:2007-03-20
Onset:2007-03-20
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Petechiae

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': WAES0703USA04554

Write-up:Information has been received from a physician concerning a female who was under 18 years old who on 20-MAR-2007 was vaccinated IM with her second dose of Gardasil. On 20-MAR-2007, within 12 hours after vaccination the patient experienced joint achiness. On 22-MAR-2007, the patient sought medical attention and the Nurse practitioner reported that the patient experienced "petikia" on her face and a red bump on the white of her one eye. Nurse Practitioner reported that the patient had no reaction to her 1st dose of Gardasil, but they are not planning to vaccinate the patient with the 3rd dose at this time. No further information is available.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276885&WAYBACKHISTORY=ON


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