National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279454

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279454
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-26
Onset:2007-03-26
Submitted:2007-05-23
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Nausea, Oedema peripheral, Pain in extremity

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 13 year old female who on 26-MAR-2007 was vaccinated with Gardasil. On 26-MAR-2007 the patient developed swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and di"fficulty breathing. The patient went to the emergency room and was treated with Phenergan. Subsequently, the patient recovered. The nurse practitioner reported that she never saw this type of reaction before and that the patient never reacted to any other


Changed on 12/8/2009

279454 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-26
Onset:2007-03-26
Submitted:2007-05-23
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Nausea, Oedema peripheral, Pain in extremity, Swelling face, Vomiting

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0705USA03775

Write-up:Information has been received from a nurse practitioner concerning a 13 year old female who on 26-MAR-2007 was vaccinated with Gardasil. On 26-MAR-2007 the patient developed swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and di"fficulty difficulty breathing. The patient went to the emergency room and was treated with Phenergan. Subsequently, the patient recovered. The nurse practitioner reported that she never saw this type of reaction before and that the patient never reacted to any other vaccine. The reporter felt that the swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and difficulty breathing were other important medial events. Additional information has been requested.


Changed on 9/14/2017

279454 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-26
Onset:2007-03-26
Submitted:2007-05-23
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Nausea, Oedema peripheral, Pain in extremity, Swelling face, Vomiting

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA03775

Write-up:Information has been received from a nurse practitioner concerning a 13 year old female who on 26-MAR-2007 was vaccinated with Gardasil. On 26-MAR-2007 the patient developed swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and difficulty breathing. The patient went to the emergency room and was treated with Phenergan. Subsequently, the patient recovered. The nurse practitioner reported that she never saw this type of reaction before and that the patient never reacted to any other vaccine. The reporter felt that the swelling of the arm, arm and chest pain, nausea, vomiting, facial swelling and difficulty breathing were other important medial events. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279454&WAYBACKHISTORY=ON


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