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This is VAERS ID 279678

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279678
VAERS Form:
Age:9.0
Gender:Female
Location:Utah
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Nausea, Pain in extremity

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:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 9 year old female who on 10-APR-2007 was vaccinated with Gardasil. On 11-APR-2007 the patient experienced a sore arm and nausea. This is one of two reports received from the same source. Addition"al information has been requested.


Changed on 12/8/2009

279678 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Utah
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Nausea, Pain in extremity

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:
CDC 'Split Type': (blank) WAES0705USA00653

Write-up:Information has been received from a physician concerning a 9 year old female who on 10-APR-2007 was vaccinated with Gardasil. On 11-APR-2007 the patient experienced a sore arm and nausea. This is one of two reports received from the same source. Addition"al Additional information has been requested.


Changed on 9/14/2017

279678 Before After
VAERS Form:(blank) 1
Age:9.0
Gender:Female
Location:Utah
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Nausea, Pain in extremity

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:
CDC 'Split Type': WAES0705USA00653

Write-up:Information has been received from a physician concerning a 9 year old female who on 10-APR-2007 was vaccinated with Gardasil. On 11-APR-2007 the patient experienced a sore arm and nausea. This is one of two reports received from the same source. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279678&WAYBACKHISTORY=ON


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