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This is VAERS ID 279504

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279504
VAERS Form:
Age:20.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Chest pain, Dyspnoea, Muscle spasms, Limb discomfort

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U."Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. In April 2007 patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours afte


Changed on 12/8/2009

279504 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Chest pain, Dyspnoea, Muscle spasms, Limb discomfort

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U."Concomitant #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. In April 2007 patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours afte after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 3/2/2010

279504 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Unknown Maryland
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Chest pain, Dyspnoea, Muscle spasms, Limb discomfort

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown electrocardiogram, 04/20/07, within normal limits; chest computed axial, 04/20/07, within normal limits
CDC 'Split Type': WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. In April 2007 On 16-APR-2007, the patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 4/7/2010

279504 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Chest pain, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Muscle spasms, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: electrocardiogram, 04/20/07, within normal limits; chest computed axial, 04/20/07, within normal limits
CDC 'Split Type': WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. On 16-APR-2007, the patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 6/14/2014

279504 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Chest pain, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Muscle spasms, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: electrocardiogram, 04/20/07, within normal limits; chest computed axial, 04/20/07, within normal limits
CDC 'Split Type': WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. On 16-APR-2007, the patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 5/14/2017

279504 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Chest pain, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Muscle spasms, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: electrocardiogram, 04/20/07, within normal limits; chest computed axial, 04/20/07, within normal limits
CDC 'Split Type': WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. On 16-APR-2007, the patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 9/14/2017

279504 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Maryland
Vaccinated:2007-02-02
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Chest pain, Computerised tomogram normal, Dyspnoea, Electrocardiogram normal, Muscle spasms, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: ORTHO TRI-CYCLEN LO
Current Illness: Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: electrocardiogram, 04/20/07, within normal limits; chest computed axial, 04/20/07, within normal limits
CDC 'Split Type': WAES0704USA04293

Write-up:Information has been received from an office receptionist concerning a 20 year old female patient with family history of heart disease, allergic reaction to antibiotics, who on 02-FEB-2007 was vaccinated IM with a first dose of Gardasil lot #654741/0013U. Concomitant therapy included Ortho Tri-Cyclean Lo. On 02-FEB-2007 the patient developed arm soreness but otherwise felt fine. On 16-APR-2007, the patient was vaccinated IM with the second dose of Gardasil lot #657621/0387U. Within one to one and half hours after the second injection patient developed muscle spasm in chest area which radiated from left chest to center. She described pain as sharp intermittent and took her breath away. On 18-APR-2007 she took Advil for something else (not specified) and it helped pain a little but was not relieved. The physician instructed patient to go the emergency room (ER). Patient was planning to go to the ER on 19-APR-2007. At the time of this report the patient had not recovered. Additional information has been requested.


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