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This is VAERS ID 279568

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279568
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pain, Musculoskeletal pain

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female who is not pregnant who was vaccinated with Gardasil. Subsequently, the patient experienced injection site pain about one week after vaccination. The pain diminished for a whil"e and then returned as significant shoulder pain. She had no other vaccinations at the same time. She has had no treatment so far. She had sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

279568 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pain, Musculoskeletal pain

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA06024

Write-up:Information has been received from a physician concerning a 16 year old female who is not pregnant who was vaccinated with Gardasil. Subsequently, the patient experienced injection site pain about one week after vaccination. The pain diminished for a whil"e while and then returned as significant shoulder pain. She had no other vaccinations at the same time. She has had no treatment so far. She had sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

279568 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site pain, Musculoskeletal pain

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA06024

Write-up:Information has been received from a physician concerning a 16 year old female who is not pregnant who was vaccinated with Gardasil. Subsequently, the patient experienced injection site pain about one week after vaccination. The pain diminished for a while and then returned as significant shoulder pain. She had no other vaccinations at the same time. She has had no treatment so far. She had sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279568&WAYBACKHISTORY=ON


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