National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 283731

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283731
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1163F / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Drug administered at inappropriate site, Injection site pain

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: Unknown
Current Illness: Oral herpes; Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA03786

Write-up:Initial and follow up information has been received from an office manager in a physician''s office, concerning a 16 year old black female patient with no known drug allergies, oral herpes and asthma who on 18-JAN-2007 at approximately 3:30pm, was vaccinated IM in the right gluteal, with the first dose of Gardasil (Lot #654540/1163F). The patient experienced some pain during the administration of the vaccine (previously reported as no symptoms), but subsequently recovered (date unspecified). The patient''s mother, who was a nurse, had questioned the office3 about the effectiveness of the vaccine, after she received training of correct Gardasil administration. On 19-MAR-2007, at approximately 3:45pm, the patient received the second dose, IM in the right deltoid, of Gardasil (Lot #654702/0011U), with no problems reported. No further information is expected.


Changed on 9/14/2017

283731 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2007-01-18
Onset:2007-01-18
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1163F / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Drug administered at inappropriate site, Injection site pain

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: Unknown
Current Illness: Oral herpes; Asthma
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA03786

Write-up:Initial and follow up information has been received from an office manager in a physician''s office, concerning a 16 year old black female patient with no known drug allergies, oral herpes and asthma who on 18-JAN-2007 at approximately 3:30pm, was vaccinated IM in the right gluteal, with the first dose of Gardasil (Lot #654540/1163F). The patient experienced some pain during the administration of the vaccine (previously reported as no symptoms), but subsequently recovered (date unspecified). The patient''s mother, who was a nurse, had questioned the office3 about the effectiveness of the vaccine, after she received training of correct Gardasil administration. On 19-MAR-2007, at approximately 3:45pm, the patient received the second dose, IM in the right deltoid, of Gardasil (Lot #654702/0011U), with no problems reported. No further information is expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283731&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166