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This is VAERS ID 289290

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 289290
VAERS Form:
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Appendicitis

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

Write-up: Information has been received from a physician''''s assistant (PA), via a company representative, regarding a 17 year old female patient, who /"months ago/" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccinati"on, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 12/8/2009

VAERS ID: 289290 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0707USA02026

Write-up: Information has been received from a physician''''s physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who /"months ago/" "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccinati"on, vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 1/5/2010

VAERS ID: 289290 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 6/14/2014

VAERS ID: 289290 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 5/14/2017

VAERS ID: 289290 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 9/14/2017

VAERS ID: 289290 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 2/14/2018

VAERS ID: 289290 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 6/14/2018

VAERS ID: 289290 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 8/14/2018

VAERS ID: 289290 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 9/14/2018

VAERS ID: 289290 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

Changed on 10/14/2018

VAERS ID: 289290 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Pennsylvania
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-08-14
Entered:2007-08-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Appendicitis

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=289290&WAYBACKHISTORY=ON


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