First Appeared on 12/30/2006 |
| VAERS ID: |
263220
|
Vaccinated: |
2006-08-21 |
| Age: |
22.0 |
Onset: |
2006-08-21 |
| Gender: |
Female |
Submitted: |
2006-09-14 |
| Location: |
Illinois |
Entered: |
2006-09-19 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: ORTHO TRI CYCLEN |
| Current Illness: |
| Preexisting Conditions: CONCURRENT CONDITIONS: drug hypersensitivity |
| Diagnostic Lab Data: NONE |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) |
MERCK & CO. INC. |
|
|
|
UN |
|
| Administered by: Other
Purchased by: Unknown |
| Symptoms: Loss of consciousness |
| Write-up: Information has been received from a 22 year old female with an allergy to meperidine hydrochloride (DEMEROL) who on 21-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTH"O TRI CYCLEN). On 21-AUG-2006, following the vaccination, the patient fainted. Unspecified medical attention was sought. At the time of this report, the patient was recovering. Additional information has been requested. |
|
|
Changed on 12/8/2009 |
| VAERS ID: |
263220 Before
After
|
Vaccinated: |
2006-08-21 |
| Age: |
22.0 |
Onset: |
2006-08-21 |
| Gender: |
Female |
Submitted: |
2006-09-14 |
| Location: |
Illinois |
Entered: |
2006-09-19 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? No |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: ORTHO TRI CYCLEN |
| Current Illness: |
| Preexisting Conditions: CONCURRENT CONDITIONS: drug hypersensitivity |
| Diagnostic Lab Data: NONE |
CDC 'Split Type':
(blank)
WAES0608USA05414 |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL)/HPV (GARDASIL) |
MERCK & CO. INC. |
|
|
|
UN |
|
| Administered by: Other
Purchased by: Unknown/Other |
| Symptoms: Loss of consciousness |
Write-up:
Information has been received from a 22 year old female with an allergy to meperidine hydrochloride (DEMEROL) who on 21-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTH"O (ORTHO TRI CYCLEN). On 21-AUG-2006, following the vaccination, the patient fainted. Unspecified medical attention was sought. At the time of this report, the patient was recovering. Additional information has been requested.
|
|
|
