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This is VAERS ID 279220

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279220
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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

Write-up:Information has been received from a Medical Assistant (M.A.) concerning an 18 year old female patient who on 04-NOV-2007 was vaccinated in deltoid with a dose of Gardasil lot #656049/0187U. Concomitant therapy included Depo-Provera in the other arm. The"patient developed hives about four hours after receiving Gardasil. Benadryl was ordered. The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 279220 Before After
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / - - / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA02838

Write-up:Information has been received from a Medical Assistant (M.A.) concerning an 18 year old female patient who on 04-NOV-2007 was vaccinated in deltoid with a dose of Gardasil lot #656049/0187U. Concomitant therapy included Depo-Provera in the other arm. The"patient The patient developed hives about four hours after receiving Gardasil. Benadryl was ordered. The patient''''s patient''s outcome was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279220&WAYBACKHISTORY=ON


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