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This is VAERS ID 264757

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264757
Age:25.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 653937/0637F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraception
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a physician and a registered nurse concerning a 25 year old female who on 01-SEP-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included hormonal contraceptives ("unspecified). On approximately 08-SEP-2006, one week after vaccination, the patient developed /"small bumps under her skin/" at the injection site. The patient sought unspecified medical attention. Subsequently, the patient fully recovered.

Changed on 12/8/2009

VAERS ID: 264757 Before After
Age:25.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
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. 653937/0637F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraception
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0609USA05017

Write-up:Information has been received from a physician and a registered nurse concerning a 25 year old female who on 01-SEP-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included hormonal contraceptives ("unspecified). (unspecified). On approximately 08-SEP-2006, one week after vaccination, the patient developed /"small "small bumps under her skin/" skin" at the injection site. The patient sought unspecified medical attention. Subsequently, the patient fully recovered.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264757&WAYBACKHISTORY=ON


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