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This is VAERS ID 279317

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279317
VAERS Form:
Age:17.0
Gender:Female
Location:Hawaii
Vaccinated:2007-05-02
Onset:2007-05-09
Submitted:2007-05-17
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Receive vaccine 5/2/07 L deltoid. No initial reaction (no fever, pain, swelling at site). On 5/9/07 noticed painful swelling L deltoid with redness, increased to maximum size evening 5/9/07. Pt seen on 5/10/07 and had 2 1/2 cm subcutaneous erythematous ar"ea of induration - mobile, mildly tender on left deltoid (pt said smaller then previous night). On phone following 5/12/07 pt said swelling almost gone (only small bump - nontender).


Changed on 12/8/2009

279317 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Hawaii
Vaccinated:2007-05-02
Onset:2007-05-09
Submitted:2007-05-17
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Receive vaccine 5/2/07 L deltoid. No initial reaction (no fever, pain, swelling at site). On 5/9/07 noticed painful swelling L deltoid with redness, increased to maximum size evening 5/9/07. Pt seen on 5/10/07 and had 2 1/2 cm subcutaneous erythematous ar"ea area of induration - mobile, mildly tender on left deltoid (pt said smaller then previous night). On phone following 5/12/07 pt said swelling almost gone (only small bump - nontender).


Changed on 9/14/2017

279317 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Hawaii
Vaccinated:2007-05-02
Onset:2007-05-09
Submitted:2007-05-17
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site induration, Injection site pain, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Receive vaccine 5/2/07 L deltoid. No initial reaction (no fever, pain, swelling at site). On 5/9/07 noticed painful swelling L deltoid with redness, increased to maximum size evening 5/9/07. Pt seen on 5/10/07 and had 2 1/2 cm subcutaneous erythematous area of induration - mobile, mildly tender on left deltoid (pt said smaller then previous night). On phone following 5/12/07 pt said swelling almost gone (only small bump - nontender).


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