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This is VAERS ID 279515

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279515
Age:21.0
Gender:Female
Location:Tennessee
Vaccinated:0000-00-00
Onset:2007-04-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 1 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site irritation, Injection site pain, Contusion

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified), ADDERALL TABLETS
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a Certified Medical Assistant (C.M.A.) concerning a 21 year old female patient who on 08-FEB-2007 was vaccinated IM with a first dose of Gardasil and on 17-APR-2007 was vaccinated IM in the left deltoid a second dose of"Gardasil lot #655849/0263U. Concomitant therapy included Adderall Tablets and thyroid medication (therapy unspecified). A few days after receiving the second injection, the patient developed tenderness, soreness, erythema, swelling. warmth, burning and pr


Changed on 12/8/2009

VAERS ID: 279515 Before After
Age:21.0
Gender:Female
Location:Tennessee
Vaccinated:0000-00-00
Onset:2007-04-01
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 1 LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site irritation, Injection site pain, Injection site pruritus, Injection site warmth, Contusion, Injection site swelling

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified), ADDERALL TABLETS
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA05057

Write-up:Information has been received from a Certified Medical Assistant (C.M.A.) concerning a 21 year old female patient who on 08-FEB-2007 was vaccinated IM with a first dose of Gardasil and on 17-APR-2007 was vaccinated IM in the left deltoid a second dose of"Gardasil of Gardasil lot #655849/0263U. Concomitant therapy included Adderall Tablets and thyroid medication (therapy unspecified). A few days after receiving the second injection, the patient developed tenderness, soreness, erythema, swelling. warmth, burning and pr pruritus in the injection site area of her left arm. She also developed a red bruise on her chest, medical attention was sought. Patient had not recovered. Additional information has been requested.


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