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This is VAERS ID 279250

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279250
VAERS Form:
Age:23.0
Gender:Female
Location:Washington
Vaccinated:2007-04-19
Onset:2007-04-20
Submitted:2007-05-21
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Condition aggravated, Dyspnoea

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: VENTOLINE (ALBUTEROL SULFATE, LORATIDINE D, SINGULAIR
Current Illness: Asthma; Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a 23 year old black/white female receptionist with asthma (diagnosed at the age of 5 year old) and outdoor allergies who on 19-APR-2007 at 01:15 (AM or PM not reported) was vaccinated IM"in left arm deltoid with a first dose of Gardasil lot #655849/0263U. Concomitant therapy included montelukast sodium (MSD) loratadine (+) pseudoephedrine sulfate (LORATIDINE D) and albuterol sulfate (VENTOLINE (albuterol sulfate)). On 20-APR-2007, Friday


Changed on 12/8/2009

279250 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Washington
Vaccinated:2007-04-19
Onset:2007-04-20
Submitted:2007-05-21
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Asthma, Condition aggravated, Dyspnoea

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: VENTOLINE (ALBUTEROL SULFATE, LORATIDINE D, SINGULAIR
Current Illness: Asthma; Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0705USA02873

Write-up:Information has been received from a health professional concerning a 23 year old black/white female receptionist with asthma (diagnosed at the age of 5 year old) and outdoor allergies who on 19-APR-2007 at 01:15 (AM or PM not reported) was vaccinated IM"in IM in left arm deltoid with a first dose of Gardasil lot #655849/0263U. Concomitant therapy included montelukast sodium (MSD) loratadine (+) pseudoephedrine sulfate (LORATIDINE D) and albuterol sulfate (VENTOLINE (albuterol sulfate)). On 20-APR-2007, Friday night at 11:00 PM patient woke up with short of breath. Her rescue inhaler did not help so she used her nebulizer. On 21-APR-2007 she used her nebulizer again around 6:30 AM and through out that day 4 to 6x. On 22-APR-2007, Sunday she did 6 nebulizer treatment within one-two hours before being admitted at the hospital. In the hospital she had additional nebulizer treatment (10+) times and steroid injections. Patient stated that this was her worst asthma attack since being diagnosed. Patient recovered. Additional information is not expected.


Changed on 9/14/2017

279250 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Washington
Vaccinated:2007-04-19
Onset:2007-04-20
Submitted:2007-05-21
Entered:2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Asthma, Condition aggravated, Dyspnoea

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications: VENTOLINE (ALBUTEROL SULFATE, LORATIDINE D, SINGULAIR
Current Illness: Asthma; Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA02873

Write-up:Information has been received from a health professional concerning a 23 year old black/white female receptionist with asthma (diagnosed at the age of 5 year old) and outdoor allergies who on 19-APR-2007 at 01:15 (AM or PM not reported) was vaccinated IM in left arm deltoid with a first dose of Gardasil lot #655849/0263U. Concomitant therapy included montelukast sodium (MSD) loratadine (+) pseudoephedrine sulfate (LORATIDINE D) and albuterol sulfate (VENTOLINE (albuterol sulfate)). On 20-APR-2007, Friday night at 11:00 PM patient woke up with short of breath. Her rescue inhaler did not help so she used her nebulizer. On 21-APR-2007 she used her nebulizer again around 6:30 AM and through out that day 4 to 6x. On 22-APR-2007, Sunday she did 6 nebulizer treatment within one-two hours before being admitted at the hospital. In the hospital she had additional nebulizer treatment (10+) times and steroid injections. Patient stated that this was her worst asthma attack since being diagnosed. Patient recovered. Additional information is not expected.


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