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This is VAERS ID 264675

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

264675
VAERS Form:
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested pos"itive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


Changed on 12/8/2009

264675 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
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: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0610USA05710

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested pos"itive positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


Changed on 12/13/2013

264675 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA05710

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


Changed on 6/14/2014

264675 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA05710

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


Changed on 3/14/2015

264675 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA05710

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


Changed on 9/14/2017

264675 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Texas
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Hepatitis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA05710

Write-up:Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested.


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