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This is VAERS ID 284130

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 284130
Age:21.0
Gender:Female
Location:Washington
Vaccinated:2007-03-16
Onset:2007-03-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Body temperature increased, Hallucination, Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy; drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: body temp, 03/16/07, 103 F
CDC 'Split Type': WAES0705USA03139

Write-up:Information has been received from a nurse concerning a 21 year old female with allergies to amoxicillin and cefaclor who on 16-MAR-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 657006/0188U). During the evening of 16-MAR-2007 the patient developed a fever of 103 F, a severe headache, and hallucinations. The patient was treated with alternating doses of acetaminophen and ibuprofen. By the morning of 17-MAR-2007, "all issues resolved" and the patient recovered. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 284130 Before After
Age:21.0
Gender:Female
Location:Washington
Vaccinated:2007-03-16
Onset:2007-03-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 UN / IM

Administered by: Other Private      Purchased by: Other
Symptoms: Body temperature increased, Hallucination, Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy; drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: body temp, 03/16/07, 103 F
CDC 'Split Type': WAES0705USA03139

Write-up:Information has been received from a nurse concerning a 21 year old female with allergies to amoxicillin and cefaclor and no illness at the time of vaccination who on 16-MAR-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 657006/0188U). During the evening of 16-MAR-2007 the patient developed a fever of 103 102-103 F, a severe headache, and hallucinations. The patient was treated with alternating doses of acetaminophen and ibuprofen. By the morning of 17-MAR-2007, "all issues resolved" and the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. No additional information is expected.


Changed on 6/14/2014

VAERS ID: 284130 Before After
Age:21.0
Gender:Female
Location:Washington
Vaccinated:2007-03-16
Onset:2007-03-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Body temperature increased, Hallucination, Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy; drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: body temp, 03/16/07, 103 F
CDC 'Split Type': WAES0705USA03139

Write-up:Information has been received from a nurse concerning a 21 year old female with allergies to amoxicillin and cefaclor and no illness at the time of vaccination who on 16-MAR-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 657006/0188U). During the evening of 16-MAR-2007 the patient developed a fever of 102-103 F, a severe headache, and hallucinations. The patient was treated with alternating doses of acetaminophen and ibuprofen. By the morning of 17-MAR-2007, "all issues resolved" and the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. No additional information is expected.


Changed on 5/14/2017

VAERS ID: 284130 Before After
Age:21.0
Gender:Female
Location:Washington
Vaccinated:2007-03-16
Onset:2007-03-16
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 UN / IM

Administered by: Private      Purchased by: Other
Symptoms: Body temperature increased, Hallucination, Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy; drug hypersensitivity
Preexisting Conditions:
Diagnostic Lab Data: body temp, 03/16/07, 103 F
CDC 'Split Type': WAES0705USA03139

Write-up:Information has been received from a nurse concerning a 21 year old female with allergies to amoxicillin and cefaclor and no illness at the time of vaccination who on 16-MAR-2007 was vaccinated intramuscularly with a 0.5 mL first dose of Gardasil (lot 657006/0188U). During the evening of 16-MAR-2007 the patient developed a fever of 102-103 F, a severe headache, and hallucinations. The patient was treated with alternating doses of acetaminophen and ibuprofen. By the morning of 17-MAR-2007, "all issues resolved" and the patient recovered. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. No additional information is expected.


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