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This is VAERS ID 267430

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267430
VAERS Form:
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced s"harp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''''s office to be evaluated. At the time of the report, the


Changed on 12/8/2009

267430 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
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. 0688F / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA08344

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced s"harp sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''''s physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


Changed on 2/5/2010

267430 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 - / -

Administered by: Other Public      Purchased by: Other Public
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: UNK Unknown
Allergies:
Diagnostic Lab Data: UNK Unknown
CDC 'Split Type': WAES0610USA08344

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of GARASIL (lot #653735/0688F). There was no concomitant medication. On 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information is not available.


Changed on 6/14/2014

267430 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 - / -

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0610USA08344

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of GARASIL (lot #653735/0688F). There was no concomitant medication. On 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information is not available.


Changed on 5/14/2017

267430 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 - / -

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0610USA08344

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of GARASIL (lot #653735/0688F). There was no concomitant medication. On 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information is not available.


Changed on 9/14/2017

267430 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Florida
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 1 - / -

Administered by: Public      Purchased by: Public
Symptoms: Abdominal pain, Dysuria, Vaginal pain

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: NONE
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0610USA08344

Write-up:Information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of HPV (lot # 653735/0688F). There was no concomitant medication. on 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a certified medical assistant concerning a 16 year old female who on 05-OCT-2006 was vaccinated with a first dose of GARASIL (lot #653735/0688F). There was no concomitant medication. On 06-OCT-2006 the patient experienced sharp pain around the abdomen area and vaginal area and intense pain during urination. It was reported that the pain was on and off. It was reported that the patient was going to go to the physician''s office to be evaluated. At the time of the report, the patient''s outcome was unknown. Additional information is not available.


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