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This is VAERS ID 264751

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264751
Age:9.0
Gender:Female
Location:Pennsylvania
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. UNK / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Concurrent conditions: sulfonamide allergy
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four"days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 264751 Before After
Age:9.0
Gender:Female
Location:Pennsylvania
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. UNK / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: Concurrent conditions: sulfonamide allergy
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0609USA04418

Write-up:Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four"days. four days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 264751 Before After
Age:9.0 19.0
Gender:Female
Location:Pennsylvania
Vaccinated:0000-00-00 2006-08-01
Onset:0000-00-00 2006-08-01
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. UNK / - 0 - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK EFFEXOR
Current Illness: Sulfonamide allergy
Preexisting Conditions: Concurrent conditions: sulfonamide allergy
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA04418

Write-up:Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested. This is a follow-up to report (s). Information has been received from a physician concerning his 19 year old daughter with a sulfonamide allergy and no other pertinent medical history reported. In August 2006, the patient was vaccinated with the first dose of GARDASIL by another health care professional. Concomitant therapy included EFFEXOR. In approximately August 2006, "about 4 days after being vaccinated", the patient developed a primary herpetic gingivostomatitis on her lips. The patient sought unspecified medical attention. All symptoms had resolved. At the time of this report. The patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 264751 Before After
Age:19.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. UNK / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EFFEXOR
Current Illness: Sulfonamide allergy
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA04418

Write-up:Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested. This is a follow-up to report (s). Information has been received from a physician concerning his 19 year old daughter with a sulfonamide allergy and no other pertinent medical history reported. In August 2006, the patient was vaccinated with the first dose of GARDASIL by another health care professional. Concomitant therapy included EFFEXOR. In approximately August 2006, "about 4 days after being vaccinated", the patient developed a primary herpetic gingivostomatitis on her lips. The patient sought unspecified medical attention. All symptoms had resolved. At the time of this report. The patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 264751 Before After
Age:19.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-08-01
Onset:2006-08-01
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. UNK / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: EFFEXOR
Current Illness: Sulfonamide allergy
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0609USA04418

Write-up:Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested. This is a follow-up to report (s). Information has been received from a physician concerning his 19 year old daughter with a sulfonamide allergy and no other pertinent medical history reported. In August 2006, the patient was vaccinated with the first dose of GARDASIL by another health care professional. Concomitant therapy included EFFEXOR. In approximately August 2006, "about 4 days after being vaccinated", the patient developed a primary herpetic gingivostomatitis on her lips. The patient sought unspecified medical attention. All symptoms had resolved. At the time of this report. The patient had recovered from the event (date unknown). Additional information has been requested.


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