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This is VAERS ID 279926

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279926
VAERS Form:
Age:18.0
Gender:Female
Location:Maryland
Vaccinated:2007-05-22
Onset:2007-05-24
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dyspnoea, Food allergy, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: None
Preexisting Conditions: nuts (only reaction, runny nose)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:On 5/22/07 rec''''d vaccine. On 5/24/07 when at work and mixing cappuccino from powder (powder became aerosolized) Pt started with hives and SOB. Seen in ES and rec''''d Benadryl. Pt told by allergist had /"small allergy to nuts/" of skin testing at cappuccin"o powder has nuts.


Changed on 12/8/2009

279926 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Maryland
Vaccinated:2007-05-22
Onset:2007-05-24
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Dyspnoea, Food allergy, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: None
Preexisting Conditions: nuts (only reaction, runny nose)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:On 5/22/07 rec''''d rec''d vaccine. On 5/24/07 when at work and mixing cappuccino from powder (powder became aerosolized) Pt started with hives and SOB. Seen in ES and rec''''d rec''d Benadryl. Pt told by allergist had /"small "small allergy to nuts/" nuts" of skin testing at cappuccin"o cappuccino powder has nuts.


Changed on 9/14/2017

279926 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Maryland
Vaccinated:2007-05-22
Onset:2007-05-24
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Dyspnoea, Food allergy, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness: None
Preexisting Conditions: nuts (only reaction, runny nose)
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:On 5/22/07 rec''d vaccine. On 5/24/07 when at work and mixing cappuccino from powder (powder became aerosolized) Pt started with hives and SOB. Seen in ES and rec''d Benadryl. Pt told by allergist had "small allergy to nuts" of skin testing at cappuccino powder has nuts.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279926&WAYBACKHISTORY=ON


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