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This is VAERS ID 279240

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279240
VAERS Form:
Age:14.0
Gender:Female
Location:Minnesota
Vaccinated:2007-01-18
Onset:2007-01-19
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: Dizziness, Urticaria, Vomiting, Weight decreased, Laboratory test

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: diagnostic laboratory - results not provided
CDC 'Split Type':

Write-up:Information has been received from the mother of a 14 year old female with no pertinent medical history or drug reactions/allergies, who on 18-JAN-2007 was vaccinated with Gardasil (0.5 ml). There was no concomitant medication. On 19-JAN-2007 the patient"experienced hives, vomiting, dizziness and weight loss. At the time of this report, the patient''''s hives, vomiting, dizziness and weight loss persisted. Unspecified medical attention was sought and it was reported that the patient underwent blood tests (r


Changed on 12/8/2009

279240 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Minnesota
Vaccinated:2007-01-18
Onset:2007-01-19
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: Dizziness, Urticaria, Vomiting, Weight decreased, Laboratory test

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: diagnostic laboratory - results not provided
CDC 'Split Type': (blank) WAES0704USA03595

Write-up:Information has been received from the mother of a 14 year old female with no pertinent medical history or drug reactions/allergies, who on 18-JAN-2007 was vaccinated with Gardasil (0.5 ml). There was no concomitant medication. On 19-JAN-2007 the patient"experienced patient experienced hives, vomiting, dizziness and weight loss. At the time of this report, the patient''''s patient''s hives, vomiting, dizziness and weight loss persisted. Unspecified medical attention was sought and it was reported that the patient underwent blood tests (r (results not provided). Additional information has been requested.


Changed on 9/14/2017

279240 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Minnesota
Vaccinated:2007-01-18
Onset:2007-01-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Urticaria, Vomiting, Weight decreased, Laboratory test

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: diagnostic laboratory - results not provided
CDC 'Split Type': WAES0704USA03595

Write-up:Information has been received from the mother of a 14 year old female with no pertinent medical history or drug reactions/allergies, who on 18-JAN-2007 was vaccinated with Gardasil (0.5 ml). There was no concomitant medication. On 19-JAN-2007 the patient experienced hives, vomiting, dizziness and weight loss. At the time of this report, the patient''s hives, vomiting, dizziness and weight loss persisted. Unspecified medical attention was sought and it was reported that the patient underwent blood tests (results not provided). Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279240&WAYBACKHISTORY=ON


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