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This is VAERS ID 284178

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284178
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-27
Onset:2007-05-18
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Injection site warmth

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her"left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vacc


Changed on 12/8/2009

284178 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-27
Onset:2007-05-18
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site induration, Injection site pain, Injection site warmth

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0705USA04028

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her"left her left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vacc vaccine of Gardasil. However, on approximately 18-MAY-2007 the patient experienced warmth, pain and hardness at the injection site where Gardasil was given. It was reported that the patient sought unspecified medical attention. No further details were provided. Additional information has been requested.


Changed on 3/2/2010

284178 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Unknown Ohio
Vaccinated:2007-04-27 2007-02-09
Onset:2007-05-18 2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Unknown Public      Purchased by: Unknown Public
Symptoms: Injection site induration, Injection site pain, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04028

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vaccine of Gardasil. However, on approximately 18-MAY-2007 01-MAY-2007 the patient experienced warmth, pain and hardness at the injection site where Gardasil was given. It was reported that the patient sought unspecified medical attention. No further details were provided. Additional information has been requested.


Changed on 6/14/2014

284178 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-09
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site induration, Injection site pain, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04028

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vaccine of Gardasil. However, on approximately 01-MAY-2007 the patient experienced warmth, pain and hardness at the injection site where Gardasil was given. It was reported that the patient sought unspecified medical attention. No further details were provided. Additional information has been requested.


Changed on 5/14/2017

284178 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-09
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site induration, Injection site pain, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04028

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vaccine of Gardasil. However, on approximately 01-MAY-2007 the patient experienced warmth, pain and hardness at the injection site where Gardasil was given. It was reported that the patient sought unspecified medical attention. No further details were provided. Additional information has been requested.


Changed on 9/14/2017

284178 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2007-02-09
Onset:2007-05-01
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 2 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site induration, Injection site pain, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04028

Write-up:Information has been received from a physician concerning a 17 year old female who on 09-FEB-2007 was vaccinated with Gardasil (Lot #655205/1426F). On 27-APR-2007 the patient received her second dose of Gardasil (Lot #655619/1427F) which was given in her left upper arm. Concomitant therapy included medroxyprogesterone acetate (DEPE-PROVERA) which was given to the patient on 27-APR-2007 in the right arm. It was reported that the patient did not experience any adverse effects with the first dose of the vaccine of Gardasil. However, on approximately 01-MAY-2007 the patient experienced warmth, pain and hardness at the injection site where Gardasil was given. It was reported that the patient sought unspecified medical attention. No further details were provided. Additional information has been requested.


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