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| VAERS ID: | 262847 | Vaccinated: | 2006-09-06 | | Age: | 25.0 | Onset: | 2006-09-06, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-11, Days after onset: 5 | | Location: | Kentucky | Entered: | 2006-09-11, Days after submission: 0 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: yearly examination | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | | MNQ | AVENTIS PASTEUR | U2117AA | 0 | IM | RA | |
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| VAERS ID: | 262872 | Vaccinated: | 2006-09-02 | | Age: | 11.0 | Onset: | 2006-09-02, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-02, Days after onset: 0 | | Location: | Florida | Entered: | 2006-09-12, Days after submission: 10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: vital signs stable | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 08007 | 0 | IM | LA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Syncope, Tonic clonic movements | | Write-up: Immediately after vaccine administration patient had syncopal episode with tonic posturing fell from table. Responded with gentle stimulation versus normal 5 minutes post regaining full consciousness. |
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| VAERS ID: | 263024 | Vaccinated: | 2006-09-11 | | Age: | 1.5 | Onset: | 0000-00-00 | | Gender: | Male | Submitted: | 2006-09-11 | | Location: | North Carolina | Entered: | 2006-09-13, Days after submission: 2 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP | SANOFI PASTEUR | U1751AB | 3 | IM | RL | | HPV4 | MERCK & CO. INC. | | | UN | UN | | PNC | WYETH PHARMACEUTICALS, INC | B08682H | 2 | IM | LL | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Wrong drug administered | | Write-up: Wrong vaccine was given Gardasil was given instead of Hep A by mistake. |
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| VAERS ID: | 263032 | Vaccinated: | 2006-07-07 | | Age: | 15.0 | Onset: | 2006-07-20, Days after vaccination: 13 | | Gender: | Female | Submitted: | 2006-08-24, Days after onset: 35 | | Location: | Illinois | Entered: | 2006-09-14, Days after submission: 21 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? Yes, 1 days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Adderall | | Preexisting Conditions: Attention deficit disorder. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | UN | | MNQ | SANOFI PASTEUR | U2069AA | 0 | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity | | Write-up: Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos. Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent. Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened. Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair. Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP. Exam showed definite weakness of all extremities, esp upper extremities, & neck. Reflexes were absent in legs. Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help. Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records. Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT. Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands. Now able to rise from sitting on floor w/o support. Still no reflexes in legs. Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss |
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| VAERS ID: | 263185 | Vaccinated: | 2006-08-29 | | Age: | 15.0 | Onset: | 2006-08-29, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-08-31, Days after onset: 2 | | Location: | New York | Entered: | 2006-09-19, Days after submission: 19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Singulair, Allegra, Flovent, Rhinocort | | Preexisting Conditions: Asthma, Penicillin allergy. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dysphagia | | Write-up: 2 hours after Gardasil Administration pt developed inability to swallow. Advised to take Benadryl by covering physician and go to ER. In ER not given EPI but Solumedrol to take for 5 days. |
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| VAERS ID: | 263200 | Vaccinated: | 2006-07-25 | | Age: | | Onset: | 2006-07-25, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 51 | | Location: | Unknown | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA00410 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a pharmacist concerning her daughter who on approximately 25-JUL-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). On approximately 25-JUL-2006 the patient experienced soreness at the injection site that lasted approximately one week and at the time of this report had not resolved. Additional information has been requested. |
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| VAERS ID: | 263201 | Vaccinated: | 2006-08-02 | | Age: | | Onset: | 2006-08-02, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 43 | | Location: | New York | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA01129 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a registered nurse concerning a female who on 02-AUG-2006 was vaccinated with the first dose of HPV rLi 3 11 16 18 VLP vaccine (yeast). It was reported that the patient fainted "shortly after receiving the vaccination". The nurse did not feel the experience was vaccine related and stated "the patient was very uneasy with the idea of an injection". The patient subsequently recovered "shortly after fainting". Unspecified medical attention was sought. Additional information has been requested. |
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| VAERS ID: | 263202 | Vaccinated: | 2006-08-03 | | Age: | 14.0 | Onset: | 2006-08-04, Days after vaccination: 1 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 41 | | Location: | Colorado | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: CLARITIN, vitamins (unspecified) | | Preexisting Conditions: MEDICAL HISTORY: fever, CONCURRENT CONDITIONS: seasonal allergy | | CDC 'Split Type': WAES0608USA01355 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pruritus, Rash, Rash papular, Skin burning sensation, Skin ulcer | | Write-up: Information has been received from a registered nurse concerning a 14 year old female with seasonal allergies who was exposed to roseola on 25-JUL-2006 and had a fever on 02-AUG-2006. On 03-AUG-2006, the patient was vaccinated intramuscularly with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653937/0637F). Concomitant therapy included loratadine (CLARITIN) and vitamins (unspecified). On 04-AUG-2006, the patient developed an extensive rash. The patient discovered the rash at 7 am on the back of her legs. It was reported that the rash spread to her back and shoulders and had started to spread to her abdomen. The rash consisted of non vesicular papular single lesions that were slightly larger than a pinpoint and too numerous to count. The lesions were described as "burning and itchy". Unspecified medical attention was sought. At the time of the report, the patient's rash persisted. Additional information has been requested. |
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| VAERS ID: | 263203 | Vaccinated: | 2006-08-09 | | Age: | 26.0 | Onset: | 2006-08-09, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 36 | | Location: | Texas | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA02569 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Arthralgia, Influenza like illness, Nausea, Pain, Pyrexia | | Write-up: Information has been received form a physician concerning a 29 year old female with no pertinent medical history and no history of drug reactions allergies who on 8/9/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653937/0637F) inappropriate schedule of vaccina administration. There was no concomitant medication. On 8/9/06 the pt experienced a fever, nausea, body aches, joint pains and experienced flu like symptoms. Unspecified medical attention was sought. At the time of this report, the pt was recovering from the fever, nausea, body aches, joint pains and flu like symptoms. |
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| VAERS ID: | 263204 | Vaccinated: | 2006-07-18 | | Age: | 21.0 | Onset: | 2006-07-18, Days after vaccination: 0 | | Gender: | Female | Submitted: | 2006-09-14, Days after onset: 58 | | Location: | Kentucky | Entered: | 2006-09-19, Days after submission: 5 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Blood pressure 7/18/06 130/80 records received 7/18/07-Positive yeast vaginal culture. BX on 5/30/07-mild sysplasia/HPV | | Previous Vaccinations: | | Other Medications: Ortho Tri cyclen Lo | | Preexisting Conditions: Pap smear abnormal, Dysplasia, Breast Prosthesis user. 7/18/07-records received-HX papular condyloma. | | CDC 'Split Type': WAES0608USA02804 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0640F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Deafness, Dizziness, Dysarthria, Injection site pain, Musculoskeletal pain, Musculoskeletal stiffness, Pallor, Shock, Skin papilloma, Speech disorder, Syncope, Tinnitus, Vision blurred | | Write-up: Initial and follow up information has been received from a 21 year old female with breast implants and had a history of abnormal pap test and dysplasia and from a nurse practitioner. On 7/18/06 the pt was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0640F). Concomitant therapy included ethinyl estradiol + norgestimate (Ortho Lo). On 7/18/06, immediately following vaccination, the pt experienced slurred speech for approx 3 to 4 minutes and reported that she felt as if her body went into shock. She noted that her fingers curled into a fist and her fingers and hands stiffened up. She reported that the later symptoms lasted for approx 25 to 30 minutes. Also approx two weeks after receiving the vaccination, she began to have some pain and stiffness in her upper left arm and shoulder in the same arm she had received the injection. Unspecified medical attention was sought. At the time of this report, the pain and stiffness in the left arm and shoulder had not resolved. The pt also reported that although she had never had nay type of genital warts in the past, on approx 8/4/06 she noted she had small genital warts which were confirmed by her health care professional. In follow up th nurse practitioner reported conflicting information that what the pt described was not what she and another nurse witnesses. The nurse practitioner stated that following the injection the pt appeared pale and almost fainted. The pt became woozy and could speak clearly. The pt was attended to by both the nurse practitioner and another nurse. The pt was diagnosed with having a near syncopal episode. The pt was treated with a cool compress and she recovered quickly and was noted as fine afterwards. The pts blood pressure was fine noted at 130/80 mmHg. it was reported that the pt did not experience any drop in hart rate, did not loose consciousness, did not seize and did not experience wheezing. The nurse practitioner did not see what she would describe as any adverse reaction to the vaccines and described th |
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