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This is VAERS ID 263232

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263232
VAERS Form:
Age:26.0
Gender:Female
Location:New Jersey
Vaccinated:2006-08-21
Onset:2006-08-21
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / -

Administered by: Public      Purchased by: Unknown
Symptoms: Laboratory test abnormal, Unevaluable event

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: ORTHO TRI CYCLEN
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 08/21/2006 /"comprehensive metabolic panel tests/", electrocardiogram 08/21/06, absolute neutrophil 08/21/06 7.9 K/ul 2.0-609, total urine ketones 08/21/06 $g-80 negative, urine bacteria screen 08/21/2006 4+, urine WBC co
CDC 'Split Type':

Write-up:Information has been received from an other health professional concerning a 26 year old female in sales with no pre-existing allergies, birth defects or medical conditions reported. On 21-AUG-2006, in the pm, the patient was vaccinated in the left delto"id with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). There were no illness noted at the time of vaccination. On 21-AUG-2006, in the pm, the p


Changed on 12/8/2009

263232 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:New Jersey
Vaccinated:2006-08-21
Onset:2006-08-21
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. 0702F / 0 UN / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Laboratory test abnormal, Unevaluable event

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: ORTHO TRI CYCLEN
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 08/21/2006 /"comprehensive "comprehensive metabolic panel tests/", tests", electrocardiogram 08/21/06, absolute neutrophil 08/21/06 7.9 K/ul 2.0-609, total urine ketones 08/21/06 $g-80 negative, urine bacteria screen 08/21/2006 4+, urine WBC co
CDC 'Split Type': (blank) WAES0608USA06478

Write-up:Information has been received from an other health professional concerning a 26 year old female in sales with no pre-existing allergies, birth defects or medical conditions reported. On 21-AUG-2006, in the pm, the patient was vaccinated in the left delto"id deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). There were no illness noted at the time of vaccination. On 21-AUG-2006, in the pm, the p patient experienced an unspecified adverse event. The patient went to the emergency room and it was reported that she "went home that day". On 21-AUG-2006, the patient underwent a complete blood count (CBC), comprehensive metabolic panel, estimated glomerular filtration rate (GFR), urine microscopic analysis, urinalysis and an electrocardiogram (EKG). On 21-AUG-2006, the patient''s laboratory data revealed an absolute neutrophil count noted as 7.9 K/ul, urine ketones noted as $g-80, a urine white blood cell count noted as 30-40/hpf and urine bacteria noted as 4+. On 21-AUG-2006, the patient recovered from the events. Additional information has been requested.


Changed on 5/14/2017

263232 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:New Jersey
Vaccinated:2006-08-21
Onset:2006-08-21
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / -

Administered by: Public      Purchased by: Private
Symptoms: Laboratory test abnormal, Unevaluable event

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: ORTHO TRI CYCLEN
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 08/21/2006 "comprehensive metabolic panel tests", electrocardiogram 08/21/06, absolute neutrophil 08/21/06 7.9 K/ul 2.0-609, total urine ketones 08/21/06 $g-80 negative, urine bacteria screen 08/21/2006 4+, urine WBC co count 08/21/06 30-40 hpf 0-2/hpf, urine microscopic 08/21/06, urinalysis 08/21/06, glomerular filtration 08/21/06, complete blood cell 08/21/06
CDC 'Split Type': WAES0608USA06478

Write-up:Information has been received from an other health professional concerning a 26 year old female in sales with no pre-existing allergies, birth defects or medical conditions reported. On 21-AUG-2006, in the pm, the patient was vaccinated in the left deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). There were no illness noted at the time of vaccination. On 21-AUG-2006, in the pm, the patient experienced an unspecified adverse event. The patient went to the emergency room and it was reported that she "went home that day". On 21-AUG-2006, the patient underwent a complete blood count (CBC), comprehensive metabolic panel, estimated glomerular filtration rate (GFR), urine microscopic analysis, urinalysis and an electrocardiogram (EKG). On 21-AUG-2006, the patient''s laboratory data revealed an absolute neutrophil count noted as 7.9 K/ul, urine ketones noted as $g-80, a urine white blood cell count noted as 30-40/hpf and urine bacteria noted as 4+. On 21-AUG-2006, the patient recovered from the events. Additional information has been requested.


Changed on 9/14/2017

263232 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:New Jersey
Vaccinated:2006-08-21
Onset:2006-08-21
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 1 UN / -

Administered by: Public      Purchased by: Private
Symptoms: Laboratory test abnormal, Unevaluable event

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: ORTHO TRI CYCLEN
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 08/21/2006 "comprehensive metabolic panel tests", electrocardiogram 08/21/06, absolute neutrophil 08/21/06 7.9 K/ul 2.0-609, total urine ketones 08/21/06 $g-80 negative, urine bacteria screen 08/21/2006 4+, urine WBC count 08/21/06 30-40 hpf 0-2/hpf, urine microscopic 08/21/06, urinalysis 08/21/06, glomerular filtration 08/21/06, complete blood cell 08/21/06
CDC 'Split Type': WAES0608USA06478

Write-up:Information has been received from an other health professional concerning a 26 year old female in sales with no pre-existing allergies, birth defects or medical conditions reported. On 21-AUG-2006, in the pm, the patient was vaccinated in the left deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). There were no illness noted at the time of vaccination. On 21-AUG-2006, in the pm, the patient experienced an unspecified adverse event. The patient went to the emergency room and it was reported that she "went home that day". On 21-AUG-2006, the patient underwent a complete blood count (CBC), comprehensive metabolic panel, estimated glomerular filtration rate (GFR), urine microscopic analysis, urinalysis and an electrocardiogram (EKG). On 21-AUG-2006, the patient''s laboratory data revealed an absolute neutrophil count noted as 7.9 K/ul, urine ketones noted as $g-80, a urine white blood cell count noted as 30-40/hpf and urine bacteria noted as 4+. On 21-AUG-2006, the patient recovered from the events. Additional information has been requested.


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