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This is VAERS ID 288955

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 288955
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Angioedema, Face oedema, Lip swelling, Pruritus generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema


Changed on 12/8/2009

VAERS ID: 288955 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Angioedema, Face oedema, Lip swelling, Swelling face, Urticaria, Urticaria generalised, Pruritus generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 5/14/2017

VAERS ID: 288955 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Angioedema, Face oedema, Lip swelling, Swelling face, Urticaria, Urticaria generalised, Pruritus generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 9/14/2017

VAERS ID: 288955 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 0 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 2/14/2018

VAERS ID: 288955 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 6/14/2018

VAERS ID: 288955 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 8/14/2018

VAERS ID: 288955 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 9/14/2018

VAERS ID: 288955 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.


Changed on 10/14/2018

VAERS ID: 288955 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-24
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1061U / 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Face oedema, Swelling face, Urticaria generalised

Life Threatening? Yes
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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: no
Current Illness: no
Preexisting Conditions: no PMH: childhood asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Anaphylactic/ type I/ reaction within 12 hours of vaccine Gardasil generalized urticaria, facial oedema. 10/16/07 Received ER medical records of 8/24/2007 which reveal patient experienced hives, swollen lips & face & itching all over. Tx w/epi, IV steroids, IV antihistamine. Improved & d/c to home FINAL DX: angioedema.

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