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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 264755 |
VAERS Form: | |
Age: | 25.0 |
Sex: | Female |
Location: | Unknown |
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. | 653650/0702F / - | - / IM |
Administered by: Other Purchased by: Unknown
Symptoms: Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM"in the deltoid described as /"pre-filled syringe one time./" Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medic
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
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. | 653650/0702F / - | - / IM |
Administered by: Other Purchased by: Unknown Other
Symptoms: Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM"in IM in the deltoid described as /"pre-filled "pre-filled syringe one time./" time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medic medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 653650/0702F 0702F / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / - | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / - UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Vaccinated: | 2006-09-20 |
Onset: | 2006-09-21 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-17 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0702F / UNK | - / IM |
Administered by: Other Purchased by: Other
Symptoms: Pyrexia
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: LEXAPRO, RITALIN
Current Illness:
Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0609USA05006
Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient''s fever of 100 degrees F. persisted. Additional information has been requested.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264755&WAYBACKHISTORY=ON
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