National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 283796

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283796
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-01
Onset:2007-05-05
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA01804

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.


Changed on 3/2/2010

283796 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown Florida
Vaccinated:2007-05-01
Onset:2007-05-05
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA01804

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.


Changed on 6/14/2014

283796 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Florida
Vaccinated:2007-05-01
Onset:2007-05-05
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA01804

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.


Changed on 5/14/2017

283796 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Florida
Vaccinated:2007-05-01
Onset:2007-05-05
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA01804

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.


Changed on 9/14/2017

283796 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Florida
Vaccinated:2007-05-01
Onset:2007-05-05
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA01804

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with no pertinent medical history or a history of drug reactions or allergies who on 01-MAY-2007 was vaccinated with her first dose of Gardasil, 0.5 ml, IM, left deltoid. There was no concomitant medication. On 05-MAY-2007 the patient developed hives. The patient was instructed to take diphenhydramine (BENADRYL). No laboratory tests were done. As of 08-MAY-2007, the patient was recovering. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283796&WAYBACKHISTORY=ON


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