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This is VAERS ID 279070

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279070
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-03-29
Onset:2007-03-29
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type':

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on"29-MAR-2007 the patient /"experienced headache, nausea and general achy symptoms./" At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

279070 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-03-29
Onset:2007-03-29
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unk
Current Illness:
Preexisting Conditions: Unk
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': (blank) WAES0704USA00966

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on"29-MAR-2007 on 29-MAR-2007 the patient /"experienced "experienced headache, nausea and general achy symptoms./" symptoms." At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 3/2/2010

279070 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-03-29 2007-04-04
Onset:2007-03-29 2007-04-05
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U 0245U / 0 UN / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unk Unknown
Current Illness:
Preexisting Conditions: Unk Unknown
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': WAES0704USA00966

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on 29-MAR-2007 the patient "experienced headache, nausea and general achy symptoms." At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Follow-information was received from the CMA, which stated that the patient was administered her first doseof GARDASIL (656050/0245U) IM in the left arm on 04-Apr-2007 at 3:30 pm. 10:00 am on 05-Apr-2007, onset of the patient''s experiences began and lasted 48 hours. She was treated with MOTRIN, and received on 07-Apr-2007. Medical attention was not sought. No further information was provided.


Changed on 6/14/2014

279070 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-04-04
Onset:2007-04-05
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': WAES0704USA00966

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on 29-MAR-2007 the patient "experienced headache, nausea and general achy symptoms." At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Follow-information was received from the CMA, which stated that the patient was administered her first doseof GARDASIL (656050/0245U) IM in the left arm on 04-Apr-2007 at 3:30 pm. 10:00 am on 05-Apr-2007, onset of the patient''s experiences began and lasted 48 hours. She was treated with MOTRIN, and received on 07-Apr-2007. Medical attention was not sought. No further information was provided.


Changed on 3/14/2015

279070 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-04-04
Onset:2007-04-05
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': WAES0704USA00966

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on 29-MAR-2007 the patient "experienced headache, nausea and general achy symptoms." At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Follow-information was received from the CMA, which stated that the patient was administered her first doseof GARDASIL (656050/0245U) IM in the left arm on 04-Apr-2007 at 3:30 pm. 10:00 am on 05-Apr-2007, onset of the patient''s experiences began and lasted 48 hours. She was treated with MOTRIN, and received on 07-Apr-2007. Medical attention was not sought. No further information was provided.


Changed on 9/14/2017

279070 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-04-04
Onset:2007-04-05
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0245U / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, Nausea, Pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unk
CDC 'Split Type': WAES0704USA00966

Write-up:Information has been received from a certified medical assistant (CMA), via a company representative, concerning a 14 year old female patient, who on 29-MAR-2007 was vaccinated with the first dose of Gardasil (Lot # 656372/0243U). The CMA reported that on 29-MAR-2007 the patient "experienced headache, nausea and general achy symptoms." At the time of this report, the patient had recovered from the events. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. Follow-information was received from the CMA, which stated that the patient was administered her first doseof GARDASIL (656050/0245U) IM in the left arm on 04-Apr-2007 at 3:30 pm. 10:00 am on 05-Apr-2007, onset of the patient''s experiences began and lasted 48 hours. She was treated with MOTRIN, and received on 07-Apr-2007. Medical attention was not sought. No further information was provided.


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