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This is VAERS ID 267429

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267429
Age:22.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-05
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Hypoaesthesia, Injection site erythema, Injection site mass

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Latex allergy; Drug hypersensitivity; Iodine allergy
Preexisting Conditions: Vaccination adverse reaction
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician and a 22 year old white female certified medical assistant with latex allergy, drug hypersensitivity to pertussis and iodine allergy and a history of unspecified adverse reaction after first dose of diphtheri"a toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid (at less than 1 year of age. On 05-OCT-2006, at 4:00 PM,. the patient was vaccinated, into the right arm, with a first dose of HPV (lot # 653978/0955F). On 05-OCT-2006, at 4:00 PM, the patie


Changed on 12/8/2009

VAERS ID: 267429 Before After
Age:22.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-05
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. 0955F / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Dizziness, Fatigue, Hypoaesthesia, Injection site erythema, Injection site mass, Malaise, Pruritus, Pyrexia, Thermal burn

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Latex allergy; Drug hypersensitivity; Iodine allergy
Preexisting Conditions: Vaccination adverse reaction
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA08337

Write-up:Information has been received from a physician and a 22 year old white female certified medical assistant with latex allergy, drug hypersensitivity to pertussis and iodine allergy and a history of unspecified adverse reaction after first dose of diphtheri"a diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid (at less than 1 year of age. On 05-OCT-2006, at 4:00 PM,. the patient was vaccinated, into the right arm, with a first dose of HPV (lot # 653978/0955F). On 05-OCT-2006, at 4:00 PM, the patie patient experienced burning "as if the arm was cut with razor blade and alcohol was poured on cut," and it "hurt really bad." The patient also developed dizziness, numbness in her lower arm, fever, fatigue, and malaise. She reported that her arm swelled up 2 times the normal size and was red. She developed a dime size lump and redness at the injection site that was itchy when touched or pressed on. Unspecified medical attention was sought. At the time of the report, the dime size lump, redness and itching at the injection site persisted. No further information is available.


Changed on 5/14/2017

VAERS ID: 267429 Before After
Age:22.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-05
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Fatigue, Hypoaesthesia, Injection site erythema, Injection site hypersensitivity, Injection site mass, Malaise, Pruritus, Pyrexia, Thermal burn

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Latex allergy; Drug hypersensitivity; Iodine allergy
Preexisting Conditions: Vaccination adverse reaction
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA08337

Write-up:Information has been received from a physician and a 22 year old white female certified medical assistant with latex allergy, drug hypersensitivity to pertussis and iodine allergy and a history of unspecified adverse reaction after first dose of diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid (at less than 1 year of age. On 05-OCT-2006, at 4:00 PM,. the patient was vaccinated, into the right arm, with a first dose of HPV (lot # 653978/0955F). On 05-OCT-2006, at 4:00 PM, the patient experienced burning "as if the arm was cut with razor blade and alcohol was poured on cut," and it "hurt really bad." The patient also developed dizziness, numbness in her lower arm, fever, fatigue, and malaise. She reported that her arm swelled up 2 times the normal size and was red. She developed a dime size lump and redness at the injection site that was itchy when touched or pressed on. Unspecified medical attention was sought. At the time of the report, the dime size lump, redness and itching at the injection site persisted. No further information is available.


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