National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 284466

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

284466
VAERS Form:
Age:21.0
Gender:Female
Location:Kentucky
Vaccinated:2007-03-13
Onset:2007-03-15
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / - LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Somnolence

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:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04246

Write-up:Information has been received from a nurse practitioner concerning a 21 year old white female student with no pertinent medical history who on 13-MAR-2007 was vaccinated intramuscularly, into the left deltoid, with a second dose of Gardasil (lot #). On 15-MAR-2007 the patient developed a rash on her face, she "wanted to sleep all day and for some reason wanted to cry." Unspecified medical attention was sought. On approximately 18-MAR-2007, the patient recovered. There were no laboratory or diagnostic tests performed. It was noted that the night before the second dose of Gardasil was administered, the patient had eaten shellfish. Although there was no history of shellfish allergy, there was a family history of shellfish allergy. No further information is expected.


Changed on 9/14/2017

284466 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Kentucky
Vaccinated:2007-03-13
Onset:2007-03-15
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0243U / - UNK LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Somnolence

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:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA04246

Write-up:Information has been received from a nurse practitioner concerning a 21 year old white female student with no pertinent medical history who on 13-MAR-2007 was vaccinated intramuscularly, into the left deltoid, with a second dose of Gardasil (lot #). On 15-MAR-2007 the patient developed a rash on her face, she "wanted to sleep all day and for some reason wanted to cry." Unspecified medical attention was sought. On approximately 18-MAR-2007, the patient recovered. There were no laboratory or diagnostic tests performed. It was noted that the night before the second dose of Gardasil was administered, the patient had eaten shellfish. Although there was no history of shellfish allergy, there was a family history of shellfish allergy. No further information is expected.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284466&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166