This is VAERS ID 263230

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID:	263230
VAERS Form:
Age:	19.0
Gender:	Female
Location:	New York

Vaccinated:	0000-00-00
Onset:	0000-00-00
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC.	- / -	UN / -

Administered by: Other Purchased by: Unknown
Symptoms: Arthralgia, Pyrexia

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and develop"ed low grade fever. Unspecified medical attention was sought. The patient''''s outcome was unknown. Additional information has been requested.

Changed on 12/8/2009

VAERS ID:	263230 Before After
VAERS Form:
Age:	19.0
Gender:	Female
Location:	New York

Vaccinated:	0000-00-00
Onset:	0000-00-00
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.	- / -	UN / -

Administered by: Other Purchased by: Unknown Other
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and develop"ed developed low grade fever. Unspecified medical attention was sought. The patient''''s patient''s outcome was unknown. Additional information has been requested.

Changed on 2/5/2010

VAERS ID:	263230 Before After
VAERS Form:
Age:	19.0 18.0
Gender:	Female
Location:	New York

Vaccinated:	0000-00-00 2006-07-27
Onset:	0000-00-00 2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	- 0688F / - 0	UN / - IM

Administered by: Other Private Purchased by: Other Private
Symptoms: Arthralgia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA06470

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient''s outcome was unknown. Additional information has been requested.

Changed on 3/2/2010

VAERS ID:	263230 Before After
VAERS Form:
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 0	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0608USA06470

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient''s outcome physician reported that the patient was unknown. recovered from her symptoms and stated "all it was was a one day flu. Additional information has been requested. is expected.

Changed on 6/14/2014

VAERS ID:	263230 Before After
VAERS Form:
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 0	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu. Additional information is expected.

Changed on 5/14/2017

VAERS ID:	263230 Before After
VAERS Form:
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 0	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu. Additional information is expected.

Changed on 9/14/2017

VAERS ID:	263230 Before After
VAERS Form:	(blank) 1
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 0 1	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu. Additional information is expected.

Changed on 2/14/2018

VAERS ID:	263230 Before After
VAERS Form:	1
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 1	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu. Additional information is expected.

Changed on 6/14/2018

VAERS ID:	263230 Before After
VAERS Form:	1
Age:	18.0
Gender:	Female
Location:	New York

Vaccinated:	2006-07-27
Onset:	2006-08-01
Submitted:	2006-09-14
Entered:	2006-09-19

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	0688F / 1	UN / IM

Administered by: Private Purchased by: Private
Symptoms: Arthralgia, Pyrexia

Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu. Additional information is expected.

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