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This is VAERS ID 279040

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279040
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2007-03-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Smear cervix abnormal, Smear cervix normal, Human papilloma virus test positive

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: None
Allergies:
Diagnostic Lab Data: Pap test 03/??/06 - negative Pap test 03/??/07 - positive for HPV with atypical squamous
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 19 year old female patient with a negative pap smear on March 2006. In October 2006, the patient was vaccinated with the first dose 0.5 mL, of Gardasil, on December 2006 with the second dose 0.5"mL of Gardasil. On 10-MAR-2007 the patient presented with positive HPV with atypical squamous cells of undetermined significance (ASCUS) pap smear after receiving second vaccination. The patient did not have the third vaccination as of this report date an


Changed on 12/8/2009

279040 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2007-03-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Smear cervix abnormal, Smear cervix normal, Human papilloma virus test positive

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: None
Allergies:
Diagnostic Lab Data: Pap test 03/??/06 - negative Pap test 03/??/07 - positive for HPV with atypical squamous
CDC 'Split Type': (blank) WAES0704USA00354

Write-up:Information has been received from a physician concerning a 19 year old female patient with a negative pap smear on March 2006. In October 2006, the patient was vaccinated with the first dose 0.5 mL, of Gardasil, on December 2006 with the second dose 0.5"mL 0.5 mL of Gardasil. On 10-MAR-2007 the patient presented with positive HPV with atypical squamous cells of undetermined significance (ASCUS) pap smear after receiving second vaccination. The patient did not have the third vaccination as of this report date an and the outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

279040 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2007-03-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Smear cervix abnormal, Smear cervix normal, Human papilloma virus test positive

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: None
Allergies:
Diagnostic Lab Data: Pap test 03/??/06 - negative Pap test 03/??/07 - positive for HPV with atypical squamous
CDC 'Split Type': WAES0704USA00354

Write-up:Information has been received from a physician concerning a 19 year old female patient with a negative pap smear on March 2006. In October 2006, the patient was vaccinated with the first dose 0.5 mL, of Gardasil, on December 2006 with the second dose 0.5 mL of Gardasil. On 10-MAR-2007 the patient presented with positive HPV with atypical squamous cells of undetermined significance (ASCUS) pap smear after receiving second vaccination. The patient did not have the third vaccination as of this report date and the outcome was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279040&WAYBACKHISTORY=ON


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