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This is VAERS ID 282643

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282643
VAERS Form:
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Dehydration, Pregnancy test positive, Urinary tract infection, Vomiting, Drug exposure during pregnancy

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: vitamins (unspecified)
Current Illness: Pregnancy NOS (LMP = 3/28/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: serum beta-human 05/10/07 posit
CDC 'Split Type':

Write-up:Information has been received from a nurse concerning a 17 year old female who on 19-JAN-2007 was vaccinated with IM with a 0.5 ml first dose of Gardasil (654389/0961F). On 10-APR-2007 was vaccinated with IM with a 0.5 ml second dose of Gardasil (657617/0"384U). Concomitant therapy included vitamins (unspecified). On 10-MAY-2007 the patient was seen in the emergency department because she experienced vomiting and dehydration. On 10-MAY-2007 serum beta-human chorionic gonadotropin test diagnosed the patient


Changed on 12/8/2009

282643 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dehydration, Pregnancy test positive, Urinary tract infection, Vomiting, Drug exposure during pregnancy

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: vitamins (unspecified)
Current Illness: Pregnancy NOS (LMP = 3/28/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: serum beta-human 05/10/07 posit
CDC 'Split Type': (blank) WAES0706USA02323

Write-up:Information has been received from a nurse concerning a 17 year old female who on 19-JAN-2007 was vaccinated with IM with a 0.5 ml first dose of Gardasil (654389/0961F). On 10-APR-2007 was vaccinated with IM with a 0.5 ml second dose of Gardasil (657617/0"384U). (657617/0384U). Concomitant therapy included vitamins (unspecified). On 10-MAY-2007 the patient was seen in the emergency department because she experienced vomiting and dehydration. On 10-MAY-2007 serum beta-human chorionic gonadotropin test diagnosed the patient as pregnant. The patient was treated with unspecified intravenous solution and ondansetron hydrochloride (ZOFRAN). Her last menstrual period was 28-MAR-2007. Estimated date of delivery was 02-JAN-2008. On approximately, 13-JUN-2007, the patient developed a urinary tract infection. The patient was treated with nitrofurantoin (MACROBID). The reporting nurse practitioner considered vomiting and dehydration and to be other important medical events. Additional information has been requested.


Changed on 9/14/2017

282643 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-04-10
Onset:2007-04-10
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dehydration, Pregnancy test positive, Urinary tract infection, Vomiting, Drug exposure during pregnancy

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: vitamins (unspecified)
Current Illness: Pregnancy NOS (LMP = 3/28/2007)
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: serum beta-human 05/10/07 posit
CDC 'Split Type': WAES0706USA02323

Write-up:Information has been received from a nurse concerning a 17 year old female who on 19-JAN-2007 was vaccinated with IM with a 0.5 ml first dose of Gardasil (654389/0961F). On 10-APR-2007 was vaccinated with IM with a 0.5 ml second dose of Gardasil (657617/0384U). Concomitant therapy included vitamins (unspecified). On 10-MAY-2007 the patient was seen in the emergency department because she experienced vomiting and dehydration. On 10-MAY-2007 serum beta-human chorionic gonadotropin test diagnosed the patient as pregnant. The patient was treated with unspecified intravenous solution and ondansetron hydrochloride (ZOFRAN). Her last menstrual period was 28-MAR-2007. Estimated date of delivery was 02-JAN-2008. On approximately, 13-JUN-2007, the patient developed a urinary tract infection. The patient was treated with nitrofurantoin (MACROBID). The reporting nurse practitioner considered vomiting and dehydration and to be other important medical events. Additional information has been requested.


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