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This is VAERS ID 284173

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284173
VAERS Form:
Age:34.0
Gender:Female
Location:Indiana
Vaccinated:2007-04-04
Onset:2007-05-21
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site reaction, Myalgia

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: YASMIN, MAXALT (RIZATRIPTAN BENZOATE)
Current Illness: Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from an approximately 34 year old female with an allergy to artificial sweeteners who on an unspecified dates, was vaccinated with the first and second doses of Gardasil. The date that therapy was started was /"about 6 months"prior to receiving the third dose. On 04-APR-2007, the patient was vaccinated with the third dose of vaccine by injection. Concomitant therapy included Yasmin. On an unspecified date, the patient experienced muscle soreness after being vaccinated. On 21-M


Changed on 12/8/2009

284173 Before After
VAERS Form:
Age:34.0
Gender:Female
Location:Indiana
Vaccinated:2007-04-04
Onset:2007-05-21
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site reaction, Myalgia

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: YASMIN, MAXALT (RIZATRIPTAN BENZOATE)
Current Illness: Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0705USA03949

Write-up:Information has been received from an approximately 34 year old female with an allergy to artificial sweeteners who on an unspecified dates, was vaccinated with the first and second doses of Gardasil. The date that therapy was started was /"about "about 6 months"prior months prior to receiving the third dose. On 04-APR-2007, the patient was vaccinated with the third dose of vaccine by injection. Concomitant therapy included Yasmin. On an unspecified date, the patient experienced muscle soreness after being vaccinated. On 21-M 21-MAY-2007, all three injection sites became visible. The patient thought it might be due to being out in the sun and being involved in physical activity. She sought unspecified medical attention. At the time of reporting, the patient was recovering. No further information was provided. Additional information has been requested.


Changed on 9/14/2017

284173 Before After
VAERS Form:(blank) 1
Age:34.0
Gender:Female
Location:Indiana
Vaccinated:2007-04-04
Onset:2007-05-21
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 3 - / -

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Myalgia

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: YASMIN, MAXALT (RIZATRIPTAN BENZOATE)
Current Illness: Hypersensitivity
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA03949

Write-up:Information has been received from an approximately 34 year old female with an allergy to artificial sweeteners who on an unspecified dates, was vaccinated with the first and second doses of Gardasil. The date that therapy was started was "about 6 months prior to receiving the third dose. On 04-APR-2007, the patient was vaccinated with the third dose of vaccine by injection. Concomitant therapy included Yasmin. On an unspecified date, the patient experienced muscle soreness after being vaccinated. On 21-MAY-2007, all three injection sites became visible. The patient thought it might be due to being out in the sun and being involved in physical activity. She sought unspecified medical attention. At the time of reporting, the patient was recovering. No further information was provided. Additional information has been requested.


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