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This is VAERS ID 284132

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 284132
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-03
Onset:2007-05-03
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03167

Write-up:Information has been received from a medical assistant concerning a 17 year old female who on 03-MAY-2007 was vaccinated with first dose of Gardasil (lot # 657622/0388U) IM in the right gluteal muscle. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient recovered. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 284132 Before After
Age:17.0
Gender:Female
Location:Unknown California
Vaccinated:2007-05-03
Onset:2007-05-03
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 UN GM / IM

Administered by: Other Private      Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03167

Write-up:Information has been received from a medical assistant concerning a 17 year old female who on 03-MAY-2007 was vaccinated with first dose of Gardasil (lot # 657622/0388U) IM in the right gluteal muscle. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, 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. Information has been received from a medical assistant concerning a 17 year old female with no illness at the time of vaccination and no history of allergies or medical conditions who on 03-MAY-2007 was vaccinated with first dose of GARDASIL (lot # 657622/0388U) IM in the right gluteal muscle at approximately 2 PM. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient had recovered. Additional information was received from a family nurse practitioner who reported that the outcome of the events was unknown (previously stated as recovered). No additional information is expected.


Changed on 6/14/2014

VAERS ID: 284132 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-05-03
Onset:2007-05-03
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 GM / IM

Administered by: Private      Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03167

Write-up:Information has been received from a medical assistant concerning a 17 year old female who on 03-MAY-2007 was vaccinated with first dose of Gardasil (lot # 657622/0388U) IM in the right gluteal muscle. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, 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. Information has been received from a medical assistant concerning a 17 year old female with no illness at the time of vaccination and no history of allergies or medical conditions who on 03-MAY-2007 was vaccinated with first dose of GARDASIL (lot # 657622/0388U) IM in the right gluteal muscle at approximately 2 PM. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient had recovered. Additional information was received from a family nurse practitioner who reported that the outcome of the events was unknown (previously stated as recovered). No additional information is expected.


Changed on 5/14/2017

VAERS ID: 284132 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-05-03
Onset:2007-05-03
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 GM / IM

Administered by: Private      Purchased by: Other
Symptoms: Drug administered at inappropriate site, Injection site erythema, Injection site mass, Injection site pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03167

Write-up:Information has been received from a medical assistant concerning a 17 year old female who on 03-MAY-2007 was vaccinated with first dose of Gardasil (lot # 657622/0388U) IM in the right gluteal muscle. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, 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. Information has been received from a medical assistant concerning a 17 year old female with no illness at the time of vaccination and no history of allergies or medical conditions who on 03-MAY-2007 was vaccinated with first dose of GARDASIL (lot # 657622/0388U) IM in the right gluteal muscle at approximately 2 PM. There was no concomitant medication. On 04-MAY-2007, the patient developed redness, a bump, and itchiness at the injection site which was the gluteus muscle. Medical attention was sought. At the time of reporting, the patient had recovered. Additional information was received from a family nurse practitioner who reported that the outcome of the events was unknown (previously stated as recovered). No additional information is expected.


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