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This is VAERS ID 279036

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279036
VAERS Form:
Age:25.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2006-09-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pain, Injection site scar

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning her 25 year old daughter who in September 2006, was vaccinated with her first dose of Gardasil, intramuscular injection in /"gluteal region/". There was no concomitant medication. In Novembe"r 2006, the patient received her second dose of Gardasil, intramuscular injection in deltoid. On 08-MAR-2007, the patient received her third dose of Gardasil, intramuscular injection in deltoid. On 09-MAR-2007, the patient experienced tenderness at inject


Changed on 12/8/2009

279036 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2006-09-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pain, Skin discolouration, Injection site scar

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA00305

Write-up:Information has been received from a registered nurse concerning her 25 year old daughter who in September 2006, was vaccinated with her first dose of Gardasil, intramuscular injection in /"gluteal region/". "gluteal region". There was no concomitant medication. In Novembe"r November 2006, the patient received her second dose of Gardasil, intramuscular injection in deltoid. On 08-MAR-2007, the patient received her third dose of Gardasil, intramuscular injection in deltoid. On 09-MAR-2007, the patient experienced tenderness at inject injection site, erythema at injection site, a raised lump size of quarter at injection site and scar at injection site which was described as the skin being discolored and having a different texture with underlying hardness. As of 02-APR-2007, the patient had not recovered. The product quality complaint unit was not involved. Additional information has been requested.


Changed on 9/14/2017

279036 Before After
VAERS Form:(blank) 1
Age:25.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2006-09-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 3 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pain, Skin discolouration, Injection site scar

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA00305

Write-up:Information has been received from a registered nurse concerning her 25 year old daughter who in September 2006, was vaccinated with her first dose of Gardasil, intramuscular injection in "gluteal region". There was no concomitant medication. In November 2006, the patient received her second dose of Gardasil, intramuscular injection in deltoid. On 08-MAR-2007, the patient received her third dose of Gardasil, intramuscular injection in deltoid. On 09-MAR-2007, the patient experienced tenderness at injection site, erythema at injection site, a raised lump size of quarter at injection site and scar at injection site which was described as the skin being discolored and having a different texture with underlying hardness. As of 02-APR-2007, the patient had not recovered. The product quality complaint unit was not involved. Additional information has been requested.


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