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This is VAERS ID 279529

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279529
VAERS Form:
Age:28.0
Gender:Female
Location:New Mexico
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, Lethargy, Malaise, Injection site swelling, Nodule

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: MIRCETE; LEVOXYL; paroxetine
Current Illness: Hypothyroidism; Drug Hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician''''s assistant concerning a 28 year old female (67inches, 227lbs.) with hypothyroidism, drug hypersensitivity to morphine sulfate, DEMEROL and ZITHROMAX who on 11-APR-2007 was vaccinated with the first dose of"Gardasil (Lot#657617/0384U) intramuscularly in the left deltoid. Concomitant therapy included paroxetine, LEVOXYL and MIRCETE. Within 24 hours, on 12-APR-2007, the patient experienced significant swelling at injection site, swelling/swollen nodular area o


Changed on 12/8/2009

279529 Before After
VAERS Form:
Age:28.0
Gender:Female
Location:New Mexico
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Inappropriate schedule of drug administration, Lethargy, Malaise, Pyrexia, Swelling, Injection site swelling, Nodule

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: MIRCETE; LEVOXYL; paroxetine
Current Illness: Hypothyroidism; Drug Hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA04810

Write-up:Information has been received from a physician''''s physician''s assistant concerning a 28 year old female (67inches, 227lbs.) with hypothyroidism, drug hypersensitivity to morphine sulfate, DEMEROL and ZITHROMAX who on 11-APR-2007 was vaccinated with the first dose of"Gardasil of Gardasil (Lot#657617/0384U) intramuscularly in the left deltoid. Concomitant therapy included paroxetine, LEVOXYL and MIRCETE. Within 24 hours, on 12-APR-2007, the patient experienced significant swelling at injection site, swelling/swollen nodular area o over left clavicle, significant malaise/lethargy and low grade fever. As of 20-APR-2007 the patient was significantly improved and considered recovered. The patient declined an appointment. Additional information has been requested.


Changed on 9/14/2017

279529 Before After
VAERS Form:(blank) 1
Age:28.0
Gender:Female
Location:New Mexico
Vaccinated:2007-04-11
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, Lethargy, Malaise, Pyrexia, Swelling, Injection site swelling, Nodule

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: MIRCETE; LEVOXYL; paroxetine
Current Illness: Hypothyroidism; Drug Hypersensitivity; Allergic reaction to antibiotics
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA04810

Write-up:Information has been received from a physician''s assistant concerning a 28 year old female (67inches, 227lbs.) with hypothyroidism, drug hypersensitivity to morphine sulfate, DEMEROL and ZITHROMAX who on 11-APR-2007 was vaccinated with the first dose of Gardasil (Lot#657617/0384U) intramuscularly in the left deltoid. Concomitant therapy included paroxetine, LEVOXYL and MIRCETE. Within 24 hours, on 12-APR-2007, the patient experienced significant swelling at injection site, swelling/swollen nodular area over left clavicle, significant malaise/lethargy and low grade fever. As of 20-APR-2007 the patient was significantly improved and considered recovered. The patient declined an appointment. Additional information has been requested.


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