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This is VAERS ID 267415

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267415
Age:27.0
Gender:Female
Location:Washington
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Erythema, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Contraceptives
Current Illness:
Preexisting Conditions: Pap Smear abnormal, Loop electrosurgical excision procedure, seasonal allergy, penicillin allergy.
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse and a medical assistant concerning a 27 year old female with seasonal allergies, a possible penicillin allergy and had a history of an abnormal Papanicolaou smear and loop electrosurgical excision proc"edure. On 8/2/06, the pt was vaccinated IM in the arm with the first 0.5ml pre filled syringe dose of HPV Vaccine (lot 653650/0640F). Concomitant therapy included unspecified hormonal contraceptive (reported as birth control pills). Following the first va


Changed on 12/8/2009

VAERS ID: 267415 Before After
Age:27.0
Gender:Female
Location:Washington
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Erythema, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Contraceptives
Current Illness:
Preexisting Conditions: Pap Smear abnormal, Loop electrosurgical excision procedure, seasonal allergy, penicillin allergy.
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0610USA02296

Write-up:Information has been received from a registered nurse and a medical assistant concerning a 27 year old female with seasonal allergies, a possible penicillin allergy and had a history of an abnormal Papanicolaou smear and loop electrosurgical excision proc"edure. procedure. On 8/2/06, the pt was vaccinated IM in the arm with the first 0.5ml pre filled syringe dose of HPV Vaccine (lot 653650/0640F). Concomitant therapy included unspecified hormonal contraceptive (reported as birth control pills). Following the first va vaccination, the pt did not experience any adverse reactions. On 10/2/06, the pt was vaccinated with the second dose of HPV vaccine. On 10/2/06, 12 hours after the vaccination, the pt woke up in the middle of the night with right red, itchy hands and feet (also reported as soaked them in ice). It was reported that the symptoms were better the afternoon of the vaccination. On 10/3/06, the pt took Benadryl. The pt sought unspecified medical attention. On 10/4/06, the registered nurse spoke with the pt in the afternoon and all symptoms had resolved. The medical assistant note that the pt had no immediate severe symptoms. The medical assistant reported that there was no mention of seriousness of events in the pts chart and reported that the events did not look like they were serious. The registered nurse further reported that she would not classify the events as serious. Additional information has been requested.


Changed on 12/13/2013

VAERS ID: 267415 Before After
Age:27.0
Gender:Female
Location:Washington
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0640F / 1 UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Contraceptives
Current Illness:
Preexisting Conditions: Pap Smear abnormal, Loop electrosurgical excision procedure, seasonal allergy, penicillin allergy.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA02296

Write-up:Information has been received from a registered nurse and a medical assistant concerning a 27 year old female with seasonal allergies, a possible penicillin allergy and had a history of an abnormal Papanicolaou smear and loop electrosurgical excision procedure. On 8/2/06, the pt was vaccinated IM in the arm with the first 0.5ml pre filled syringe dose of HPV Vaccine (lot 653650/0640F). Concomitant therapy included unspecified hormonal contraceptive (reported as birth control pills). Following the first vaccination, the pt did not experience any adverse reactions. On 10/2/06, the pt was vaccinated with the second dose of HPV vaccine. On 10/2/06, 12 hours after the vaccination, the pt woke up in the middle of the night with right red, itchy hands and feet (also reported as soaked them in ice). It was reported that the symptoms were better the afternoon of the vaccination. On 10/3/06, the pt took Benadryl. The pt sought unspecified medical attention. On 10/4/06, the registered nurse spoke with the pt in the afternoon and all symptoms had resolved. The medical assistant note that the pt had no immediate severe symptoms. The medical assistant reported that there was no mention of seriousness of events in the pts chart and reported that the events did not look like they were serious. The registered nurse further reported that she would not classify the events as serious. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 267415 Before After
Age:27.0
Gender:Female
Location:Washington
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Contraceptives
Current Illness:
Preexisting Conditions: Pap Smear abnormal, Loop electrosurgical excision procedure, seasonal allergy, penicillin allergy.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA02296

Write-up:Information has been received from a registered nurse and a medical assistant concerning a 27 year old female with seasonal allergies, a possible penicillin allergy and had a history of an abnormal Papanicolaou smear and loop electrosurgical excision procedure. On 8/2/06, the pt was vaccinated IM in the arm with the first 0.5ml pre filled syringe dose of HPV Vaccine (lot 653650/0640F). Concomitant therapy included unspecified hormonal contraceptive (reported as birth control pills). Following the first vaccination, the pt did not experience any adverse reactions. On 10/2/06, the pt was vaccinated with the second dose of HPV vaccine. On 10/2/06, 12 hours after the vaccination, the pt woke up in the middle of the night with right red, itchy hands and feet (also reported as soaked them in ice). It was reported that the symptoms were better the afternoon of the vaccination. On 10/3/06, the pt took Benadryl. The pt sought unspecified medical attention. On 10/4/06, the registered nurse spoke with the pt in the afternoon and all symptoms had resolved. The medical assistant note that the pt had no immediate severe symptoms. The medical assistant reported that there was no mention of seriousness of events in the pts chart and reported that the events did not look like they were serious. The registered nurse further reported that she would not classify the events as serious. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 267415 Before After
Age:27.0
Gender:Female
Location:Washington
Vaccinated:2006-10-02
Onset:2006-10-02
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Hormonal Contraceptives
Current Illness:
Preexisting Conditions: Pap Smear abnormal, Loop electrosurgical excision procedure, seasonal allergy, penicillin allergy.
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA02296

Write-up:Information has been received from a registered nurse and a medical assistant concerning a 27 year old female with seasonal allergies, a possible penicillin allergy and had a history of an abnormal Papanicolaou smear and loop electrosurgical excision procedure. On 8/2/06, the pt was vaccinated IM in the arm with the first 0.5ml pre filled syringe dose of HPV Vaccine (lot 653650/0640F). Concomitant therapy included unspecified hormonal contraceptive (reported as birth control pills). Following the first vaccination, the pt did not experience any adverse reactions. On 10/2/06, the pt was vaccinated with the second dose of HPV vaccine. On 10/2/06, 12 hours after the vaccination, the pt woke up in the middle of the night with right red, itchy hands and feet (also reported as soaked them in ice). It was reported that the symptoms were better the afternoon of the vaccination. On 10/3/06, the pt took Benadryl. The pt sought unspecified medical attention. On 10/4/06, the registered nurse spoke with the pt in the afternoon and all symptoms had resolved. The medical assistant note that the pt had no immediate severe symptoms. The medical assistant reported that there was no mention of seriousness of events in the pts chart and reported that the events did not look like they were serious. The registered nurse further reported that she would not classify the events as serious. Additional information has been requested.


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