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This is VAERS ID 279218

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279218
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-12
Onset:2007-04-13
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Breast pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA INJECTION
Current Illness: Contraception
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a 15 year old female who on 12-APR-2007 was vaccinated with Gardasil. Concomitant therapy included Depo-Provera Injection for birth control. On 13-APR-2007 after receiving her first dose"of the vaccine, the patient experienced soreness in her breasts and weakness. It was reported that the patient received unspecified medical attention. No further information is available. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 279218 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-12
Onset:2007-04-13
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Breast pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: DEPO-PROVERA INJECTION
Current Illness: Contraception
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA02738

Write-up:Information has been received from a health professional concerning a 15 year old female who on 12-APR-2007 was vaccinated with Gardasil. Concomitant therapy included Depo-Provera Injection for birth control. On 13-APR-2007 after receiving her first dose"of dose of the vaccine, the patient experienced soreness in her breasts and weakness. It was reported that the patient received unspecified medical attention. No further information is available. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279218&WAYBACKHISTORY=ON


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