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This is VAERS ID 279523

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279523
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Influenza like illness, Nausea

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

Write-up:Information has been received from a physician, via a company representative, concerning the physician''''s daughter, age 15 or 16 years, who on approximately 09-MAR-2007 (/"about six weeks ago/") was vaccinated, IM, with the third dose of Gardasil. The phy"sician reported that following the vaccination, his daughter experienced flu-like symptoms and nausea, that lasted for three days after the vaccine had been administered, approximately 12-MAR-2007. The physician confirmed that following the three days, hi


Changed on 12/8/2009

VAERS ID: 279523 Before After
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Influenza like illness, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA04661

Write-up:Information has been received from a physician, via a company representative, concerning the physician''''s physician''s daughter, age 15 or 16 years, who on approximately 09-MAR-2007 (/"about ("about six weeks ago/") ago") was vaccinated, IM, with the third dose of Gardasil. The phy"sician physician reported that following the vaccination, his daughter experienced flu-like symptoms and nausea, that lasted for three days after the vaccine had been administered, approximately 12-MAR-2007. The physician confirmed that following the three days, hi his daughter was "fine". The patient''s sister also experienced flu-like symptoms and nausea after vaccination with Gardasil (WAES #0704USA05005). Additional information has been requested.


Changed on 2/5/2010

VAERS ID: 279523 Before After
Age:15.0 16.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown Patent ductus arteriosus repair
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04661

Write-up:Information initial and follow up information has been received from a physician, via concerning his 16 year old daughter, with a company representative, concerning the physician''s daughter, age 15 or 16 years, history of patient ductus arteriosis (PDA) ligation who on approximately 09-MAR-2007 ("about six weeks ago") 11-JUL-2006 was vaccinated with the first dose of Gardasil, on 23-Oct-2006, with the second dose of Gardasil and on 06-APR-2007 was vaccinated, IM, with the third dose of Gardasil. The physician reported that on 07-APR-2007, the day following the vaccination, his daughter experienced flu-like symptoms symptoms, was extremely nauseated, and nausea, had severe malaise that lasted for three to four days after the vaccine had been administered, approximately 12-MAR-2007. The physician confirmed that following the three days, his daughter was "fine". administered and then recovered (approximately 12-MAR-2007). The patient''s sister also experienced flu-like symptoms and nausea and malaise after vaccination with Gardasil (WAES #0704USA05005). Additional information has been requested. is not expected.


Changed on 4/7/2010

VAERS ID: 279523 Before After
Age:16.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Malaise, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Patent ductus arteriosus repair
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04661

Write-up:initial and follow up information has been received from a physician, concerning his 16 year old daughter, with a history of patient ductus arteriosis (PDA) ligation who on 11-JUL-2006 was vaccinated with the first dose of Gardasil, on 23-Oct-2006, with the second dose of Gardasil and on 06-APR-2007 was vaccinated, IM, with the third dose of Gardasil. The physician reported that on 07-APR-2007, the day following the vaccination, his daughter experienced flu-like symptoms, was extremely nauseated, and had severe malaise that lasted for three to four days after the vaccine had been administered and then recovered (approximately 12-MAR-2007). The patient''s sister also experienced flu-like symptoms and nausea and malaise after vaccination with Gardasil (WAES #0704USA05005). Additional information is not expected.


Changed on 6/14/2014

VAERS ID: 279523 Before After
Age:16.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Malaise, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Patent ductus arteriosus repair
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04661

Write-up:initial and follow up information has been received from a physician, concerning his 16 year old daughter, with a history of patient ductus arteriosis (PDA) ligation who on 11-JUL-2006 was vaccinated with the first dose of Gardasil, on 23-Oct-2006, with the second dose of Gardasil and on 06-APR-2007 was vaccinated, IM, with the third dose of Gardasil. The physician reported that on 07-APR-2007, the day following the vaccination, his daughter experienced flu-like symptoms, was extremely nauseated, and had severe malaise that lasted for three to four days after the vaccine had been administered and then recovered (approximately 12-MAR-2007). The patient''s sister also experienced flu-like symptoms and nausea and malaise after vaccination with Gardasil (WAES #0704USA05005). Additional information is not expected.


Changed on 5/14/2017

VAERS ID: 279523 Before After
Age:16.0
Gender:Female
Location:Missouri
Vaccinated:2007-03-09
Onset:2007-03-09
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Malaise, Nausea

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Patent ductus arteriosus repair
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04661

Write-up:initial and follow up information has been received from a physician, concerning his 16 year old daughter, with a history of patient ductus arteriosis (PDA) ligation who on 11-JUL-2006 was vaccinated with the first dose of Gardasil, on 23-Oct-2006, with the second dose of Gardasil and on 06-APR-2007 was vaccinated, IM, with the third dose of Gardasil. The physician reported that on 07-APR-2007, the day following the vaccination, his daughter experienced flu-like symptoms, was extremely nauseated, and had severe malaise that lasted for three to four days after the vaccine had been administered and then recovered (approximately 12-MAR-2007). The patient''s sister also experienced flu-like symptoms and nausea and malaise after vaccination with Gardasil (WAES #0704USA05005). Additional information is not expected.


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