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This is VAERS ID 262809

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 262809
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved.
CDC 'Split Type':

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no conc"omitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in th


Changed on 12/8/2009

VAERS ID: 262809 Before After
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas
CDC 'Split Type': (blank) WAES0608USA06930

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no conc"omitant concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in th the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab.


Changed on 1/5/2010

VAERS ID: 262809 Before After
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas
CDC 'Split Type': WAES0608USA06930

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab.


Changed on 1/4/2011

VAERS ID: 262809 Before After
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas areas; mesenteric adenopathy cluster of 1-1.5cm nodes; 12 mm node in left inguinal region. Surgical biopsy/path report: benign lymph node with non-specific reactive changes including immunoblasts with associated negative flow cytometry.
CDC 'Split Type': WAES0608USA06930

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab.


Changed on 6/14/2014

VAERS ID: 262809 Before After
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas; mesenteric adenopathy cluster of 1-1.5cm nodes; 12 mm node in left inguinal region. Surgical biopsy/path report: benign lymph node with non-specific reactive changes including immunoblasts with associated negative flow cytometry.
CDC 'Split Type': WAES0608USA06930

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab.


Changed on 2/14/2017

VAERS ID: 262809 Before After
Age:17.0
Gender:Female
Location:Georgia
Vaccinated:2006-08-23
Onset:2006-08-27
Submitted:2006-09-06
Entered:2006-09-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas; mesenteric adenopathy cluster of 1-1.5cm nodes; 12 mm node in left inguinal region. Surgical biopsy/path report: benign lymph node with non-specific reactive changes including immunoblasts with associated negative flow cytometry.
CDC 'Split Type': WAES0608USA06930

Write-up:Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab.


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