First Appeared on 12/30/2006 |
| VAERS ID: |
263241
|
Vaccinated: |
0000-00-00 |
| Age: |
20.0 |
Onset: |
0000-00-00 |
| Gender: |
Female |
Submitted: |
2006-09-14 |
| Location: |
Pennsylvania |
Entered: |
2006-09-19 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: |
| Current Illness: Unknown |
| Preexisting Conditions: NONE |
| Diagnostic Lab Data: NONE |
| CDC 'Split Type': |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) |
MERCK & CO. INC. |
|
0 |
|
UN |
|
| Administered by: Other
Purchased by: Unknown |
| Symptoms: Injection site pain, Injection site swelling |
| Write-up: Information has been received from a physician concerning a female patient in her early 20''''s who was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced a high amount of pain and swelling at th"e injection site. Medical attention was sought. Subsequently, the patient recovered. Additional information has been requested. |
|
|
Changed on 12/8/2009 |
| VAERS ID: |
263241 Before
After
|
Vaccinated: |
0000-00-00 |
| Age: |
20.0 |
Onset: |
0000-00-00 |
| Gender: |
Female |
Submitted: |
2006-09-14 |
| Location: |
Pennsylvania |
Entered: |
2006-09-19 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
| Other Medications: |
| Current Illness: Unknown |
| Preexisting Conditions: NONE |
| Diagnostic Lab Data: NONE |
CDC 'Split Type':
(blank)
WAES0609USA00077 |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL)/HPV (GARDASIL) |
MERCK & CO. INC. |
|
0 |
|
UN |
|
| Administered by: Other
Purchased by: Unknown/Other |
| Symptoms: Injection site pain, Injection site swelling |
Write-up:
Information has been received from a physician concerning a female patient in her early 20''''s 20''s who was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced a high amount of pain and swelling at th"e the injection site. Medical attention was sought. Subsequently, the patient recovered. Additional information has been requested.
|
|
|
Changed on 1/5/2010 |
| VAERS ID: |
263241 Before
After
|
Vaccinated: |
0000-00-00/2006-08-29 |
| Age: |
20.0/24.0 |
Onset: |
0000-00-00/2006-08-29 |
| Gender: |
Female |
Submitted: |
2006-09-14 |
| Location: |
Pennsylvania |
Entered: |
2006-09-19 |
|
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes |
| ER or Doctor Visit? Yes |
| Hospitalized? No |
| Previous Vaccinations: |
Other Medications:
Doxycycline; ALLEGRA-D; hormonal contraceptives; AMBIEN |
| Current Illness: Unknown |
Preexisting Conditions:
NONE Unknown |
| Diagnostic Lab Data: NONE |
| CDC 'Split Type': WAES0609USA00077 |
|
| Vaccination |
Manufacturer |
Lot |
Dose |
Route |
Site |
| HPV4: HPV (GARDASIL) |
MERCK & CO. INC. |
/0589F |
0 |
|
UN/LA |
|
| Administered by: Other/Private
Purchased by: Other/Private |
| Symptoms: Injection site pain, Injection site swelling |
Write-up:
Information has been received from a physician concerning a female patient in her early 20''s who was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced a high amount of pain and swelling at the injection site. Medical attention was sought. Subsequently, the patient recovered. Additional information has been requested. 01/05/2007 Follow up information has been received from a physician concerning a 24 year old female who on 29-AUG-2006 at 9:00 a.m. was vaccinated in the left arm with her first dose of GARDASIL, lot #653736/0589F. Concomitant therapy included AMBIEN, doxycycline, ALLEGRA-D, and unspecified oral contraceptive pills. Following the vaccination, on 29-AUG-2006 at 9:00 a.m. the patient experienced pain (burning) in her left arm plus swelling and tenderness x 3 days. Additional information is not expected.
|
|
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