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This is VAERS ID 263231

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263231
VAERS Form:
Age:18.0
Gender:Male
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 an 18 year old male 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 develo"ped low grade fever. Unspecified medical attention was sought. The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

263231 Before After
VAERS Form:
Age:18.0
Gender:Male
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

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': (blank) WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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 develo"ped developed low grade fever. Unspecified medical attention was sought. The patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 1/5/2010

263231 Before After
VAERS Form:
Age:18.0
Gender:Male
Location:New York
Vaccinated:0000-00-00 2006-08-01
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. - / - UN / - UN

Administered by: Other      Purchased by: Other
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': WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected.


Changed on 7/31/2010

263231 Before After
VAERS Form:
Age:18.0
Gender:Male
Location:New York
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Influenza, 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': WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected.


Changed on 6/14/2014

263231 Before After
VAERS Form:
Age:18.0
Gender:Male
Location:New York
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Influenza, 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': WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected.


Changed on 5/14/2017

263231 Before After
VAERS Form:
Age:18.0
Gender:Male
Location:New York
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Influenza, 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': WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected.


Changed on 9/14/2017

263231 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Male
Location:New York
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Influenza, 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': WAES0608USA06471

Write-up:Information has been received from a physician concerning an 18 year old male 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. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected.


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