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This is VAERS ID 283985

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283985
VAERS Form:
Age:20.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-30
Onset:2007-05-04
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA03122

Write-up:Information has been received from a physician, via a company representative, concerning a female patient in her 20''s, who on 30-APR-2007 was vaccinated IM in the deltoid, with a 0.5ml dose of Gardasil. On 04-MAY-2007, "four days post vaccination," the patient developed "red, itchy hives at the injection site." At the time of this report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

283985 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-30
Onset:2007-05-04
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site pruritus, Injection site 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA03122

Write-up:Information has been received from a physician, via a company representative, concerning a female patient in her 20''s, who on 30-APR-2007 was vaccinated IM in the deltoid, with a 0.5ml dose of Gardasil. On 04-MAY-2007, "four days post vaccination," the patient developed "red, itchy hives at the injection site." At the time of this report, the patient had not recovered. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283985&WAYBACKHISTORY=ON


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