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This is VAERS ID 263206

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263206
VAERS Form:
Age:18.0
Gender:Female
Location:Tennessee
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Myalgia, Nausea, Pyrexia, Vomiting

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? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: body temperature 08/14/06 /"low grade fever/"
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an 18 year old who on 14-AUG-2006 was vaccinated (yeast). Concomitant therapy included an unspecified therapy (/"ESTRASTEP/"). On 14-AUG-2006 the patient experienced profuse nausea, vomiting, low"grade fever and myalgia. The patient sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested.


Changed on 12/8/2009

263206 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Tennessee
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Myalgia, Nausea, Pyrexia, Vomiting

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? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: body temperature 08/14/06 /"low "low grade fever/" fever"
CDC 'Split Type': (blank) WAES0608USA03642

Write-up:Information has been received from a physician concerning an 18 year old who on 14-AUG-2006 was vaccinated (yeast). Concomitant therapy included an unspecified therapy (/"ESTRASTEP/"). ("ESTRASTEP"). On 14-AUG-2006 the patient experienced profuse nausea, vomiting, low"grade low grade fever and myalgia. The patient sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested.


Changed on 9/14/2017

263206 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Tennessee
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Myalgia, Nausea, Pyrexia, Vomiting

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? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: body temperature 08/14/06 "low grade fever"
CDC 'Split Type': WAES0608USA03642

Write-up:Information has been received from a physician concerning an 18 year old who on 14-AUG-2006 was vaccinated (yeast). Concomitant therapy included an unspecified therapy ("ESTRASTEP"). On 14-AUG-2006 the patient experienced profuse nausea, vomiting, low grade fever and myalgia. The patient sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263206&WAYBACKHISTORY=ON


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