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This is VAERS ID 264740

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264740
Age:42.0
Gender:Female
Location:California
Vaccinated:2006-09-05
Onset:2006-09-05
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: Infection, Injection site mass, Injection site reaction, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lasix
Current Illness:
Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity.
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy inclu"ded Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not


Changed on 12/8/2009

VAERS ID: 264740 Before After
Age:42.0
Gender:Female
Location:California
Vaccinated:2006-09-05
Onset:2006-09-05
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: Infection, Injection site mass, Injection site reaction, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lasix
Current Illness:
Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity.
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0609USA02222

Write-up:Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy inclu"ded included Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not yet contacted her physician. At the time of this report, the pt had not yet recovered from the injection site reaction. No further information is expected.


Changed on 3/14/2014

VAERS ID: 264740 Before After
Age:42.0
Gender:Female
Location:California
Vaccinated:2006-09-05
Onset:2006-09-05
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: Infection, Injection site mass, Injection site reaction, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lasix
Current Illness:
Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA02222

Write-up:Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy included Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not yet contacted her physician. At the time of this report, the pt had not yet recovered from the injection site reaction. No further information is expected.


Changed on 6/14/2014

VAERS ID: 264740 Before After
Age:42.0
Gender:Female
Location:California
Vaccinated:2006-09-05
Onset:2006-09-05
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: Infection, Injection site mass, Injection site reaction, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lasix
Current Illness:
Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA02222

Write-up:Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy included Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not yet contacted her physician. At the time of this report, the pt had not yet recovered from the injection site reaction. No further information is expected.


Changed on 3/14/2015

VAERS ID: 264740 Before After
Age:42.0
Gender:Female
Location:California
Vaccinated:2006-09-05
Onset:2006-09-05
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: Infection, Injection site mass, Injection site reaction, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Wellbutrin, Lasix
Current Illness:
Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA02222

Write-up:Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy included Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not yet contacted her physician. At the time of this report, the pt had not yet recovered from the injection site reaction. No further information is expected.


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