National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279236

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279236
VAERS Form:
Age:12.0
Gender:Female
Location:Massachusetts
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. 0244U / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pruritus

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician, concerning a 12 year old female patient who on 10-APR-2007, was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656051/0244U). There was no concomitant medication. The physician reported that t"he patient developed pruritus at the injection site within minutes of the vaccine administration. Treatment included Benadryl. At the time of this report, the physician confirmed that the patient had recovered (date not specified). Additional information


Changed on 12/8/2009

279236 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Massachusetts
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. 0244U / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pruritus

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA03491

Write-up:Information has been received from a physician, concerning a 12 year old female patient who on 10-APR-2007, was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656051/0244U). There was no concomitant medication. The physician reported that t"he the patient developed pruritus at the injection site within minutes of the vaccine administration. Treatment included Benadryl. At the time of this report, the physician confirmed that the patient had recovered (date not specified). Additional information has been requested.


Changed on 9/14/2017

279236 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Massachusetts
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. 0244U / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA03491

Write-up:Information has been received from a physician, concerning a 12 year old female patient who on 10-APR-2007, was vaccinated with the first dose, 0.5ml, IM, of Gardasil (Lot #656051/0244U). There was no concomitant medication. The physician reported that the patient developed pruritus at the injection site within minutes of the vaccine administration. Treatment included Benadryl. At the time of this report, the physician confirmed that the patient had recovered (date not specified). Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279236&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166