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This is VAERS ID 279217

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279217
VAERS Form:
Age:25.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site cellulitis, Injection site swelling, Reaction to previous exposure to any vaccine

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: Unknown
Current Illness: Fever; Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a Medical Assistant (M.A.) concerning a 25 year old female patient with a history of high fever after receiving the tetanus toxoid years ago who on 13-FEB-2007 was vaccinated IM in the Left arm with a first dose of Garda"sil lot #655618/0186U. Years ago the patient developed swelling, redness and itching of left arm after the first injection and went to the Emergency Room (E.R.) and she was provided antibiotics. On an unspecified date, patient was vaccinated in Right arm


Changed on 12/8/2009

279217 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site cellulitis, Injection site swelling, Reaction to previous exposure to any vaccine

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: Unknown
Current Illness: Fever; Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA02699

Write-up:Information has been received from a Medical Assistant (M.A.) concerning a 25 year old female patient with a history of high fever after receiving the tetanus toxoid years ago who on 13-FEB-2007 was vaccinated IM in the Left arm with a first dose of Garda"sil Gardasil lot #655618/0186U. Years ago the patient developed swelling, redness and itching of left arm after the first injection and went to the Emergency Room (E.R.) and she was provided antibiotics. On an unspecified date, patient was vaccinated in Right arm with a second dose of Gardasil lot #657617/0384U. She developed swelling, redness and itching of right arm after the second injection and went to see her primary physician. The physician administered antibiotics and felt that event was Cellulitis without a cut causing the event. Patient had high fever after receiving the tetanus toxoid years ago. The patient recovered from the events. Additional information has been requested.


Changed on 9/14/2017

279217 Before After
VAERS Form:(blank) 1
Age:25.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-13
Onset:2007-02-13
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site cellulitis, Injection site swelling, Reaction to previous exposure to any vaccine

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: Unknown
Current Illness: Fever; Drug hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA02699

Write-up:Information has been received from a Medical Assistant (M.A.) concerning a 25 year old female patient with a history of high fever after receiving the tetanus toxoid years ago who on 13-FEB-2007 was vaccinated IM in the Left arm with a first dose of Gardasil lot #655618/0186U. Years ago the patient developed swelling, redness and itching of left arm after the first injection and went to the Emergency Room (E.R.) and she was provided antibiotics. On an unspecified date, patient was vaccinated in Right arm with a second dose of Gardasil lot #657617/0384U. She developed swelling, redness and itching of right arm after the second injection and went to see her primary physician. The physician administered antibiotics and felt that event was Cellulitis without a cut causing the event. Patient had high fever after receiving the tetanus toxoid years ago. The patient recovered from the events. Additional information has been requested.


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