|
VAERS ID: |
269179 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
New York |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Paraesthesia SMQs:, Peripheral neuropathy (broad), Guillain-Barre syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: UNK CDC Split Type: WAES0611USA02839
Write-up: Information has been received from a registered nurse concerning a female who "between the beginning of the September and now" (date not specified) was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently on an unspecified date, the patient experienced a "definite tingling" at the injection site. Unspecified medical attention was sought. At the time of this report, the patients outcome was unknown. No product quality complaint was involved. Additional information has been requested. |
|
VAERS ID: |
269180 (history) |
Form: |
Version 1.0 |
Age: |
14.0 |
Sex: |
Female |
Location: |
New Jersey |
Vaccinated: | 2006-11-02 |
Onset: | 2006-11-03 |
Days after vaccination: | 1 |
Submitted: |
2007-04-06 |
Days after onset: | 153 |
Entered: |
2006-12-18 |
Days after submission: | 108 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
UN / IM |
Administered by: Private Purchased by: Private Symptoms: Arthropod bite,
Menorrhagia,
Migraine,
Rash,
Urticaria SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Haemorrhage terms (excl laboratory terms) (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: None Allergies: Diagnostic Lab Data: UNK CDC Split Type: WAES0611USA02908
Write-up: Information has been received from an office manager concerning a 14 year old female who on 02-Nov-2006 was vaccinated intramuscularly in the arm with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 03-Nov-2006 the patient started her menses and experienced a migraine. On 06-Nov-2006 the patient experienced a rash on her vaccinated arm which also spread to her face. Unspecified medical attention was sought. The patient was treated with diphenhydramine (BENADRYL) and the rash had subsided. AT the time of report, the patient was recovering from the migraine. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from an office manager concerning a 14 year old female with no pertinent medical history who on 02-NOV-2006, at 15:00, was vaccinated intramuscularly in the left arm with a 0.5 ml first dose of GARDASIL. On 03-NOV-2006 the patient started her menses and experienced a migraine. On 06-NOV-2006 the patient developed hives on her vaccinated arm which also spread to her face. Unspecified medical attention was sought. The patient was treated with BENADRYL and the rash had subsided. At the time of report, the patient was recovering from the migraine. Follow-up reported that the patient had a new puppy with fleas. The pediatrician diagnosed that the rash was due to flea bites and not due to an allergy. The patient was expected to received the second dose in January 2007. No product quality complaint was involved. Additional information is not available. |
|
VAERS ID: |
269181 (history) |
Form: |
Version 1.0 |
Age: |
13.0 |
Sex: |
Female |
Location: |
Indiana |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
UN / - |
Administered by: Other Purchased by: Other Symptoms: Face oedema,
Oedema peripheral SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Angioedema (narrow), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: UNK CDC Split Type: WAES0611USA02920
Write-up: Information has been received from a physician concerning a 13 year old female who was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced swelling in her face, stomach was extended with fluids and her lower extremities were swollen. Unspecified medical attention was sought. The patient was put on "hydrosteroids". She is scheduled for a follow-up visit the week of November 13th. No product quality complaint was involved. Additional information has been requested. |
|
VAERS ID: |
269182 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
New York |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
UN / - |
Administered by: Other Purchased by: Other Symptoms: Smear cervix abnormal SMQs:
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: Pap test - positive CDC Split Type: WAES0611USA03319
Write-up: Information has been received from a physician concerning a female patient who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient''s pap smear came out positive. Medical attention was sought. Her outcome was unknown. Additional information has been requested. |
|
VAERS ID: |
269183 (history) |
Form: |
Version 1.0 |
Age: |
20.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
UN / - |
Administered by: Other Purchased by: Other Symptoms: Injection site pain SMQs:, Extravasation events (injections, infusions and implants) (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: UNK CDC Split Type: WAES0611USA03411
Write-up: Information has been received from a physician concerning a 20 year old female who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (0.5 ml). Subsequently, two weeks following vaccination, the patient experienced pain at the injection area. The patient also complained of pain in the same area when lifting her arm. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional information has been requested. |
|
VAERS ID: |
269184 (history) |
Form: |
Version 1.0 |
Age: |
18.0 |
Sex: |
Female |
Location: |
Pennsylvania |
Vaccinated: | 2006-11-02 |
Onset: | 2006-11-09 |
Days after vaccination: | 7 |
Submitted: |
2006-12-14 |
Days after onset: | 35 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / 1 |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Erythema,
Injection site pain,
Swelling SMQs:, Anaphylactic reaction (broad), Angioedema (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: UNK CDC Split Type: WAES0611USA03416
Write-up: Information has been received from a physician concerning an approximately 18 year old female who on approximately 02-Nov-2006 was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On week after vaccination, on approximately 09-Nov-2006, the patient experienced pain at the injection site, and had redness, soreness and swelling. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional information has been requested. |
|
VAERS ID: |
269185 (history) |
Form: |
Version 1.0 |
Age: |
|
Sex: |
Female |
Location: |
Illinois |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Rash SMQs:, Anaphylactic reaction (broad), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: CDC Split Type: WAES0611USA03436
Write-up: Information has been received from a physician concerning a female patient (demographics not provided) who on an unspecified date was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Subsequently the patient developed a rash on her face and stomach. The patient sought unspecified medical advice. Additional information has been requested. |
|
VAERS ID: |
269186 (history) |
Form: |
Version 1.0 |
Age: |
18.0 |
Sex: |
Female |
Location: |
Oregon |
Vaccinated: | 2006-10-30 |
Onset: | 2006-10-30 |
Days after vaccination: | 0 |
Submitted: |
2006-12-14 |
Days after onset: | 45 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0955F / 1 |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Loss of consciousness SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: TYLENOL, LEXAPRO, CLARITIN Current Illness: Preexisting Conditions: CONCURRENT CONDITIONS: Depression, Anxiety, Penicillin allergy, Sulfonamide allergy Allergies: Diagnostic Lab Data: NONE CDC Split Type: WAES0611USA03446
Write-up: Information has been received from a nurse practitioner concerning an 18 year old female with low level depression and anxiety and penicillin allergy and sulfonamide allergy who on 30-Oct-2006 was vaccinated intramuscularly in the right deltoid with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653978/0955F). Concomitant therapy included escitalopram oxalate (LEXAPRO), loratadine (CLARITIN) acetaminophen (TYLENOL). On 30-Oct-2006, following vaccination, the patient fainted. Unspecified medical attention was sought. Subsequently, the patient recovered and no other symptoms were noted. Additional information has been requested. |
|
VAERS ID: |
269187 (history) |
Form: |
Version 1.0 |
Age: |
15.0 |
Sex: |
Female |
Location: |
Arizona |
Vaccinated: | 2006-09-12 |
Onset: | 2006-09-12 |
Days after vaccination: | 0 |
Submitted: |
2006-12-14 |
Days after onset: | 93 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
0800F / 1 |
- / IM |
Administered by: Private Purchased by: Private Symptoms: Loss of consciousness,
Syncope SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypoglycaemia (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: DESOGEN Current Illness: Preexisting Conditions: CONCURRENT CONDITIONS: Polycystic ovarian syndrome Allergies: Diagnostic Lab Data: CDC Split Type: WAES0611USA03478
Write-up: Information has been received from a physician concerning an 15 year old female with a history of polycystic ovary syndrome, who on 12-Sep-2006 was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#654540/0800F). Subsequently, shortly after receiving the vaccination the patient fainted. Subsequently, the patient recovered from the syncope. Unspecified medical attention was sought. Additional information has been requested. |
|
VAERS ID: |
269188 (history) |
Form: |
Version 1.0 |
Age: |
11.0 |
Sex: |
Female |
Location: |
Colorado |
Vaccinated: | 0000-00-00 |
Onset: | 0000-00-00 |
Submitted: |
2006-12-14 |
Entered: |
2006-12-18 |
Days after submission: | 4 |
Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. |
- / UNK |
- / IM |
Administered by: Other Purchased by: Other Symptoms: Lymphadenopathy SMQs:, Drug reaction with eosinophilia and systemic symptoms syndrome (broad)
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: Other Medications: UNK Current Illness: Preexisting Conditions: UNK Allergies: Diagnostic Lab Data: CDC Split Type: WAES0611USA03479
Write-up: Information has been received from a physician''s assistant concerning a 11 year old female who on unspecified date was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Subsequently the patient developed swollen lymph nodes in groin her area. Unspecified medical attention was sought. Additional information has been requested. |
|