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This is VAERS ID 279242

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279242
VAERS Form:
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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 healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with Gardasil. There was no concomitant medication. On"19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took Benadryl for the symptoms. The hives subsequently resolved. Additional information has been requested.


Changed on 12/8/2009

279242 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

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

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) WAES0704USA03658

Write-up:Information has been received from a healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with Gardasil. There was no concomitant medication. On"19-FEB-2007, On 19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took Benadryl for the symptoms. The hives subsequently resolved. Additional information has been requested.


Changed on 3/2/2010

279242 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 0 - UN / IM

Administered by: Other Private      Purchased by: Other
Symptoms: Urticaria

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': WAES0704USA03658

Write-up:This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with Gardasil. GARDASIL. There was no concomitant medication. On 19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took Benadryl BENADRYL for the symptoms. The hives subsequently resolved. Additional information has been requested. No further information is expected.


Changed on 6/14/2014

279242 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Urticaria

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': WAES0704USA03658

Write-up:This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with GARDASIL. There was no concomitant medication. On 19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took BENADRYL for the symptoms. The hives subsequently resolved. Additional information has been requested. No further information is expected.


Changed on 5/14/2017

279242 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Urticaria

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': WAES0704USA03658

Write-up:This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with GARDASIL. There was no concomitant medication. On 19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took BENADRYL for the symptoms. The hives subsequently resolved. Additional information has been requested. No further information is expected.


Changed on 9/14/2017

279242 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-19
Onset:2007-02-19
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Urticaria

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': WAES0704USA03658

Write-up:This is in follow-up to report (s) previously submitted on 5/14/2007. Information has been received from a healthcare worker concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 19-FEB-2007 was vaccinated intramuscularly with GARDASIL. There was no concomitant medication. On 19-FEB-2007, with a few hours of receiving the vaccine, the patient developed hives. Unspecified medical attention was sought, and the patient took BENADRYL for the symptoms. The hives subsequently resolved. Additional information has been requested. No further information is expected.


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