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This is VAERS ID 283797

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 283797
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-14
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Breast pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01870

Write-up:Information has been received from a certified medical assistant concerning a 17 year old female who on 14-APR-2007 was vaccinated with the second Gardasil (date of first dose not reported). Subsequently, the patient experienced breast pain. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 283797 Before After
Age:17.0
Gender:Female
Location:Unknown Alabama
Vaccinated:2007-04-14
Onset:0000-00-00 2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Breast pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01870

Write-up:Information has been received from a certified medical assistant concerning a 17 year old female who on 14-APR-2007 was vaccinated with the second Gardasil (date of first dose not reported). Subsequently, the patient experienced breast pain. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-uo to previously submitted on 6/14/2007. Information has been received from a certified medical assistant concerning a 17 year old female who on 11-Oct-2006 was vaccinated in the right deltoid with a first dose of GARDASIL (lot 653978/0955F). On 14-APR-2007, the patient was vaccinated in the left deltoid with a second dose of GARDASIL (lot 657617/0384U). The patient had no illness at the time of vaccination. On 17-APR-2007, the patient experienced bilateral breast pain. The patient sought unspecified medical attention. The outcome was unknown. Additional information has been requested.


Changed on 4/7/2010

VAERS ID: 283797 Before After
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2007-04-14
Onset:2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Breast pain, Inappropriate schedule of drug administration

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01870

Write-up:Information has been received from a certified medical assistant concerning a 17 year old female who on 14-APR-2007 was vaccinated with the second Gardasil (date of first dose not reported). Subsequently, the patient experienced breast pain. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-uo to previously submitted on 6/14/2007. Information has been received from a certified medical assistant concerning a 17 year old female who on 11-Oct-2006 was vaccinated in the right deltoid with a first dose of GARDASIL (lot 653978/0955F). On 14-APR-2007, the patient was vaccinated in the left deltoid with a second dose of GARDASIL (lot 657617/0384U). The patient had no illness at the time of vaccination. On 17-APR-2007, the patient experienced bilateral breast pain. The patient sought unspecified medical attention. The outcome was unknown. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 283797 Before After
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2007-04-14
Onset:2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Breast pain, Inappropriate schedule of drug administration

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01870

Write-up:Information has been received from a certified medical assistant concerning a 17 year old female who on 14-APR-2007 was vaccinated with the second Gardasil (date of first dose not reported). Subsequently, the patient experienced breast pain. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-uo to previously submitted on 6/14/2007. Information has been received from a certified medical assistant concerning a 17 year old female who on 11-Oct-2006 was vaccinated in the right deltoid with a first dose of GARDASIL (lot 653978/0955F). On 14-APR-2007, the patient was vaccinated in the left deltoid with a second dose of GARDASIL (lot 657617/0384U). The patient had no illness at the time of vaccination. On 17-APR-2007, the patient experienced bilateral breast pain. The patient sought unspecified medical attention. The outcome was unknown. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 283797 Before After
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2007-04-14
Onset:2007-04-17
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Breast pain, Inappropriate schedule of drug administration

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA01870

Write-up:Information has been received from a certified medical assistant concerning a 17 year old female who on 14-APR-2007 was vaccinated with the second Gardasil (date of first dose not reported). Subsequently, the patient experienced breast pain. The patient sought unspecified medical attention. Additional information has been requested. This is in follow-uo to previously submitted on 6/14/2007. Information has been received from a certified medical assistant concerning a 17 year old female who on 11-Oct-2006 was vaccinated in the right deltoid with a first dose of GARDASIL (lot 653978/0955F). On 14-APR-2007, the patient was vaccinated in the left deltoid with a second dose of GARDASIL (lot 657617/0384U). The patient had no illness at the time of vaccination. On 17-APR-2007, the patient experienced bilateral breast pain. The patient sought unspecified medical attention. The outcome was unknown. Additional information has been requested.


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