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This is VAERS ID 276924

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276924
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-02-16
Onset:0000-00-00
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: Skin depigmentation, Injection site discolouration

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: LO/OVRAL
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a female who on 16-FEB-2007 was vaccinated with her first dose of Gardasil (lot# 654702-0011U). Concomitant therapy included ethinyl estradiol/norgestrel (LO/OVRAL). Subsequently the patient"experienced depigmentation at the right deltoid injection site. Unspecified medical attention was sought. The patient''''s outcome was reported as not recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

276924 Before After
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-02-16
Onset:0000-00-00
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: Skin depigmentation, Injection site discolouration

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: LO/OVRAL
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA05382

Write-up:Information has been received from a registered nurse concerning a female who on 16-FEB-2007 was vaccinated with her first dose of Gardasil (lot# 654702-0011U). Concomitant therapy included ethinyl estradiol/norgestrel (LO/OVRAL). Subsequently the patient"experienced patient experienced depigmentation at the right deltoid injection site. Unspecified medical attention was sought. The patient''''s patient''s outcome was reported as not recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

276924 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Connecticut
Vaccinated:2007-02-16
Onset:0000-00-00
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: Skin depigmentation, Injection site discolouration

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: LO/OVRAL
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA05382

Write-up:Information has been received from a registered nurse concerning a female who on 16-FEB-2007 was vaccinated with her first dose of Gardasil (lot# 654702-0011U). Concomitant therapy included ethinyl estradiol/norgestrel (LO/OVRAL). Subsequently the patient experienced depigmentation at the right deltoid injection site. Unspecified medical attention was sought. The patient''s outcome was reported as not recovered. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276924&WAYBACKHISTORY=ON


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