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This is VAERS ID 279190

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279190
VAERS Form:
Age:16.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-01
Onset:2007-03-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Antinuclear antibody negative, Arthritis, Rheumatoid factor, Red blood cell sedimentation rate normal, Inflammation

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown. Records received 5/25/07-ACE serum 42. Albumin 4.8. HLA-B27 positive. ANA screen negative. Rheumatoid factor 5. ESR 4.
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female who in the /"beginning of March/" on approximately 01-MAR-2007 was vaccinated with Gardasil. /"Approximately one to two weeks after receiving the first dose of Gardasil on appr"oximately 15-MAR-2007 the patient experienced symptoms of uveitis. The diagnosis was confirmed with the patient''''s eye doctor. The physician noted that it could be related to arthritis. Additional information has been requested. 05/25/07-records received.


Changed on 12/8/2009

279190 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-01
Onset:2007-03-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Unknown Other
Symptoms: Antinuclear antibody negative, Arthritis, Rheumatoid factor, Uveitis, Vision blurred, Red blood cell sedimentation rate normal, Inflammation

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown. Records received 5/25/07-ACE serum 42. Albumin 4.8. HLA-B27 positive. ANA screen negative. Rheumatoid factor 5. ESR 4.
CDC 'Split Type': (blank) WAES0704USA01692

Write-up:Information has been received from a physician concerning a 16 year old female who in the /"beginning "beginning of March/" March" on approximately 01-MAR-2007 was vaccinated with Gardasil. /"Approximately "Approximately one to two weeks after receiving the first dose of Gardasil on appr"oximately approximately 15-MAR-2007 the patient experienced symptoms of uveitis. The diagnosis was confirmed with the patient''''s patient''s eye doctor. The physician noted that it could be related to arthritis. Additional information has been requested. 05/25/07-records received. Ocular inflammation, with 3 week history of blurry vision in left eye. Impression. Acute bilateral uveitis seems most like pars planitis.


Changed on 5/14/2017

279190 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-01
Onset:2007-03-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Antinuclear antibody negative, Arthritis, Rheumatoid factor, Uveitis, Vision blurred, Red blood cell sedimentation rate normal, Inflammation

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown. Records received 5/25/07-ACE serum 42. Albumin 4.8. HLA-B27 positive. ANA screen negative. Rheumatoid factor 5. ESR 4.
CDC 'Split Type': WAES0704USA01692

Write-up:Information has been received from a physician concerning a 16 year old female who in the "beginning of March" on approximately 01-MAR-2007 was vaccinated with Gardasil. "Approximately one to two weeks after receiving the first dose of Gardasil on approximately 15-MAR-2007 the patient experienced symptoms of uveitis. The diagnosis was confirmed with the patient''s eye doctor. The physician noted that it could be related to arthritis. Additional information has been requested. 05/25/07-records received. Ocular inflammation, with 3 week history of blurry vision in left eye. Impression. Acute bilateral uveitis seems most like pars planitis.


Changed on 9/14/2017

279190 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-01
Onset:2007-03-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, Uveitis

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown. Records received 5/25/07-ACE serum 42. Albumin 4.8. HLA-B27 positive. ANA screen negative. Rheumatoid factor 5. ESR 4.
CDC 'Split Type': WAES0704USA01692

Write-up:Information has been received from a physician concerning a 16 year old female who in the "beginning of March" on approximately 01-MAR-2007 was vaccinated with Gardasil. "Approximately one to two weeks after receiving the first dose of Gardasil on approximately 15-MAR-2007 the patient experienced symptoms of uveitis. The diagnosis was confirmed with the patient''s eye doctor. The physician noted that it could be related to arthritis. Additional information has been requested. 05/25/07-records received. Ocular inflammation, with 3 week history of blurry vision in left eye. Impression. Acute bilateral uveitis seems most like pars planitis.


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