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This is VAERS ID 279503

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279503
VAERS Form:
Age:21.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1161F / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Drug administered at inappropriate site, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, YASMIN, IMITREX TABLETS, ZOMIG
Current Illness: Asthma, Polycystic ovaries; Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a registered nurse, concerning a 21 year old female student with asthma, polycystic ovaries and migraines, who on 18-DEC-2006 was vaccinated IM in the gluteal area, with the second dose, 0.5ml, of Gardasil (Lot #654540/1"161F). Concomitant therapy included Yasmin, Zomig, Imitrex tablets and albuterol inhaler. The nurse reported that the patient complained of pain at the injection site. At the time of this report, the nurse confirmed that the patient had recovered (date un


Changed on 12/8/2009

279503 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1161F / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Drug administered at inappropriate site, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, YASMIN, IMITREX TABLETS, ZOMIG
Current Illness: Asthma, Polycystic ovaries; Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA04291

Write-up:Information has been received from a registered nurse, concerning a 21 year old female student with asthma, polycystic ovaries and migraines, who on 18-DEC-2006 was vaccinated IM in the gluteal area, with the second dose, 0.5ml, of Gardasil (Lot #654540/1"161F). #654540/1161F). Concomitant therapy included Yasmin, Zomig, Imitrex tablets and albuterol inhaler. The nurse reported that the patient complained of pain at the injection site. At the time of this report, the nurse confirmed that the patient had recovered (date un unspecified). The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

279503 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-18
Onset:2006-12-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1161F / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug administered at inappropriate site, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, YASMIN, IMITREX TABLETS, ZOMIG
Current Illness: Asthma, Polycystic ovaries; Migraine
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA04291

Write-up:Information has been received from a registered nurse, concerning a 21 year old female student with asthma, polycystic ovaries and migraines, who on 18-DEC-2006 was vaccinated IM in the gluteal area, with the second dose, 0.5ml, of Gardasil (Lot #654540/1161F). Concomitant therapy included Yasmin, Zomig, Imitrex tablets and albuterol inhaler. The nurse reported that the patient complained of pain at the injection site. At the time of this report, the nurse confirmed that the patient had recovered (date unspecified). The patient sought unspecified medical attention. Additional information has been requested.


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