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This is VAERS ID 264788

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264788
Age:16.0
Gender:Female
Location:New Jersey
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. - / - - / -

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

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

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient developed headache and fever. Her outcome was"not reported. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
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. - / - - / -

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient developed headache and fever. Her outcome was"not was not reported. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:0000-00-00 2006-09-27
Onset:0000-00-00 2006-09-28
Submitted:2006-10-13 2007-05-21
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0688F / - 0 - UN / - UN

Administered by: Other Private      Purchased by: Other Private
Symptoms: Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK Unknown
Current Illness:
Preexisting Conditions: UNK None
Diagnostic Lab Data: UNK body temp, 09/28/06, 100
CDC 'Split Type': WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #553735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. This is an consolidation of two reports concerning the same patient. Additional information is not expected. WAES #0610USA01350 was previously submitted on 13-OCT-2006.


Changed on 2/5/2010

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-09-27
Onset:2006-09-28
Submitted:2007-05-21
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN RA / UN

Administered by: Private      Purchased by: Private
Symptoms: Headache, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: body Body temp, 09/28/06, 100
CDC 'Split Type': WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). GARDASIL. Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #553735/0688F, #653735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. Additional information is not expected. This is an a consolidation of two reports concerning the same patient. Additional information is not expected. WAES #0610USA01350 # 0610USA01350 was previously submitted on 13-OCT-2006.


Changed on 7/31/2010

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-09-27
Onset:2006-09-28
Submitted:2007-05-21
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / UN

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Eye pain, Headache, Pyrexia, Body temperature normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Body temp, 09/28/06, 100
CDC 'Split Type': WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of GARDASIL. Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #653735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. Additional information is not expected. This is a consolidation of two reports concerning the same patient. WAES # 0610USA01350 was previously submitted on 13-OCT-2006.


Changed on 6/14/2014

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-09-27
Onset:2006-09-28
Submitted:2007-05-21
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / UN

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Eye pain, Headache, Pyrexia, Body temperature normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Body temp, 09/28/06, 100
CDC 'Split Type': WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of GARDASIL. Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #653735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. Additional information is not expected. This is a consolidation of two reports concerning the same patient. WAES # 0610USA01350 was previously submitted on 13-OCT-2006.


Changed on 3/14/2015

VAERS ID: 264788 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-09-27
Onset:2006-09-28
Submitted:2007-05-21
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / UN

Administered by: Private      Purchased by: Private
Symptoms: Body temperature increased, Eye pain, Headache, Pyrexia, Body temperature normal

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: None
Diagnostic Lab Data: Body temp, 09/28/06, 100
CDC 'Split Type': WAES0610USA03615

Write-up:Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of GARDASIL. Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #653735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. Additional information is not expected. This is a consolidation of two reports concerning the same patient. WAES # 0610USA01350 was previously submitted on 13-OCT-2006.


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