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This is VAERS ID 279186

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279186
VAERS Form:
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-04
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number /"0284/"). Concomitant therapy included Seasonique. On 07-APR-2007 the patient experienced a 1 cm tender nodu"le at the injection site (deltoid muscle) after receiving her second dose of Gardasil on 04-APR-2007. The patient''''s tender nodule persisted. Additional information has been requested.


Changed on 12/8/2009

279186 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-04
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA01617

Write-up:Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number /"0284/"). "0284"). Concomitant therapy included Seasonique. On 07-APR-2007 the patient experienced a 1 cm tender nodu"le nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil on 04-APR-2007. The patient''''s patient''s tender nodule persisted. Additional information has been requested.


Changed on 3/2/2010

279186 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-04 2007-04-03
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0284U / - 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01617

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number "0284"). "0284U" also reported as 0284J. invalid lot #). Concomitant therapy included Seasonique. SEASONIQUE. On 07-APR-2007 the patient experienced a 1 cm tender nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil Gardasil. IM in her left delotid on 04-APR-2007. 03-APR-2007 (previously reported as 04-APR-2007). The patient''s tender nodule persisted. The patient''s outcome was unknown. Additional information has been requested. is not expected.


Changed on 6/14/2014

279186 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0284U / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01617

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number "0284U" also reported as 0284J. invalid lot #). Concomitant therapy included SEASONIQUE. On 07-APR-2007 the patient experienced a 1 cm tender nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil. IM in her left delotid on 03-APR-2007 (previously reported as 04-APR-2007). The patient''s tender nodule persisted. The patient''s outcome was unknown. Additional information is not expected.


Changed on 5/14/2017

279186 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0284U / 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01617

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number "0284U" also reported as 0284J. invalid lot #). Concomitant therapy included SEASONIQUE. On 07-APR-2007 the patient experienced a 1 cm tender nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil. IM in her left delotid on 03-APR-2007 (previously reported as 04-APR-2007). The patient''s tender nodule persisted. The patient''s outcome was unknown. Additional information is not expected.


Changed on 9/14/2017

279186 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0284U / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Injection site nodule

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: SEASONIQUE
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA01617

Write-up:This is in follow-up to report(s) previously submitted on 5/14/2007. Information has been received from a registered nurse concerning a 26 year old female who on 27-JAN-2007 was vaccinated with Gardasil (lot number "0284U" also reported as 0284J. invalid lot #). Concomitant therapy included SEASONIQUE. On 07-APR-2007 the patient experienced a 1 cm tender nodule at the injection site (deltoid muscle) after receiving her second dose of Gardasil. IM in her left delotid on 03-APR-2007 (previously reported as 04-APR-2007). The patient''s tender nodule persisted. The patient''s outcome was unknown. Additional information is not expected.


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