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This is VAERS ID 279516

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279516
Age:16.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-21
Onset:2007-04-21
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, SINGULAIR
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Initial and follow up information has been received from a Certified Registered Nurse Practitioner (CRNP) concerning a 16 year old female student with asthma who on 21-APR-2007 at 9:30 AM was vaccinated IM with a first dose of Gardasil (lot #0210U not val"id). Concomitant therapy included montelukast sodium and albuterol over the counter (OTC)-10. On 21-APR-2007 at 5:00PM the patient developed exacerbation of asthma with activity during two basketball games one at 5:00PM and one at 8:00PM. She used albuter


Changed on 12/8/2009

VAERS ID: 279516 Before After
Age:16.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-21
Onset:2007-04-21
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Asthma

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: albuterol, SINGULAIR
Current Illness: Asthma
Preexisting Conditions:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA05060

Write-up:Initial and follow up information has been received from a Certified Registered Nurse Practitioner (CRNP) concerning a 16 year old female student with asthma who on 21-APR-2007 at 9:30 AM was vaccinated IM with a first dose of Gardasil (lot #0210U not val"id). valid). Concomitant therapy included montelukast sodium and albuterol over the counter (OTC)-10. On 21-APR-2007 at 5:00PM the patient developed exacerbation of asthma with activity during two basketball games one at 5:00PM and one at 8:00PM. She used albuter albuterol 7 times during the basketball game. Normally she didn''t need to use the albuterol that many times. On 22-APR-2007 the patient recovered in the AM. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279516&WAYBACKHISTORY=ON


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