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This is VAERS ID 284260

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284260
VAERS Form:
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-26
Onset:2007-04-27
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB162CB / 1 RA / ID
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Influenza like illness, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: flu-like symptoms ~HPV (Gardasil)~1~11~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE

Write-up:This is report # 3 of 3, one for each Gardisil administered. Mother stated to me on 05/18/07, that 24 hours after Gardisil vaccines, patient had fever, and then developed flu-like symptoms. Mother feels that after Gardisil administration, patient seemed"much more susceptible to flu-like illness and various infections, e.g. sinusitis.


Changed on 12/8/2009

284260 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-26
Onset:2007-04-27
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB162CB / 1 RA / ID
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 2 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Influenza like illness, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: flu-like symptoms ~HPV (Gardasil)~1~11~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': NONE (blank)

Write-up:This is report # 3 of 3, one for each Gardisil administered. Mother stated to me on 05/18/07, that 24 hours after Gardisil vaccines, patient had fever, and then developed flu-like symptoms. Mother feels that after Gardisil administration, patient seemed"much seemed much more susceptible to flu-like illness and various infections, e.g. sinusitis.


Changed on 5/14/2017

284260 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-26
Onset:2007-04-27
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB162CB / 1 RA / ID
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: flu-like symptoms ~HPV (Gardasil)~1~11~In symptoms~HPV (Gardasil)~1~10.50~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:This is report # 3 of 3, one for each Gardisil administered. Mother stated to me on 05/18/07, that 24 hours after Gardisil vaccines, patient had fever, and then developed flu-like symptoms. Mother feels that after Gardisil administration, patient seemed much more susceptible to flu-like illness and various infections, e.g. sinusitis.


Changed on 9/14/2017

284260 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-26
Onset:2007-04-27
Submitted:2007-07-10
Entered:2007-07-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB162CB / 1 2 RA / ID
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 2 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: flu-like symptoms~HPV (Gardasil)~1~10.50~In Patient
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:This is report # 3 of 3, one for each Gardisil administered. Mother stated to me on 05/18/07, that 24 hours after Gardisil vaccines, patient had fever, and then developed flu-like symptoms. Mother feels that after Gardisil administration, patient seemed much more susceptible to flu-like illness and various infections, e.g. sinusitis.


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