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This is VAERS ID 279203

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279203
VAERS Form:
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a registered nurse, concerning a 13 year old female patient, who on 10-APR-2007 was vaccinated with the first dose of Gardasil (Lot #653938/0954F), and developed hives. At the time of this report, the patient had not rec"overed. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

279203 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Urticaria

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: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA02348

Write-up:Information has been received from a registered nurse, concerning a 13 year old female patient, who on 10-APR-2007 was vaccinated with the first dose of Gardasil (Lot #653938/0954F), and developed hives. At the time of this report, the patient had not rec"overed. recovered. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

279203 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA02348

Write-up:Information has been received from a registered nurse, concerning a 13 year old female patient, who on 10-APR-2007 was vaccinated with the first dose of Gardasil (Lot #653938/0954F), and developed hives. At the time of this report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279203&WAYBACKHISTORY=ON


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