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This is VAERS ID 283937

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283937
VAERS Form:
Age:21.0
Gender:Female
Location:Hawaii
Vaccinated:2007-05-07
Onset:2007-05-08
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 2 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Rash macular, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NUVARING
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02227

Write-up:Information has been received from a physician and follow up information from a health care professional concerning a 21 year old female patient with no drug reactions/allergies who on 07-MAY-2007 was vaccinated IM in the right deltoid with the third dose of Gardasil (Lot #657617/0384U). Concomitant therapy included ethinyl estradiol (+) etonogestrel (NUVARING). On 08-MAY-2007 the patient experienced an injection site reaction of redness, swelling and the area was hot to the touch. There were three red blotches near the injection site including the injection site. No labs were performed. Her outcome was not reported. Additional information is not expected.


Changed on 9/14/2017

283937 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Hawaii
Vaccinated:2007-05-07
Onset:2007-05-08
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 2 3 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Rash macular, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NUVARING
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02227

Write-up:Information has been received from a physician and follow up information from a health care professional concerning a 21 year old female patient with no drug reactions/allergies who on 07-MAY-2007 was vaccinated IM in the right deltoid with the third dose of Gardasil (Lot #657617/0384U). Concomitant therapy included ethinyl estradiol (+) etonogestrel (NUVARING). On 08-MAY-2007 the patient experienced an injection site reaction of redness, swelling and the area was hot to the touch. There were three red blotches near the injection site including the injection site. No labs were performed. Her outcome was not reported. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283937&WAYBACKHISTORY=ON


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