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This is VAERS ID 267436

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267436
Age:14.0
Gender:Female
Location:California
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Muscle spasms, Myalgia

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

Write-up:Information has been received from a physician concerning a 14 year old female student who on 05-Oct-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653735/0688F). Concomitant therapy given at the same time in the"same arm included a dose of hepatitis A virus vaccine (unspecified). On 06-Oct-2006, the patient experienced extremely severe cramping pain in arm at the vaccine site intermittently over about 16 hours following vaccination. The episodes lasted about 30


Changed on 12/8/2009

VAERS ID: 267436 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) HEP A (VAQTA) / MERCK & CO. INC. - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Muscle spasms, Myalgia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA09554

Write-up:Information has been received from a physician concerning a 14 year old female student who on 05-Oct-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653735/0688F). Concomitant therapy given at the same time in the"same the same arm included a dose of hepatitis A virus vaccine (unspecified). On 06-Oct-2006, the patient experienced extremely severe cramping pain in arm at the vaccine site intermittently over about 16 hours following vaccination. The episodes lasted about 30 minutes each and were incapacitating. During the time between episodes the patient was completely pain free. The episodes continued through the night with the same intensity. The episodes stopped abruptly the next morning and there was no reoccurrence. Additional information has been requested.


Changed on 3/14/2014

VAERS ID: 267436 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2006-10-05
Onset:2006-10-06
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / - - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Muscle spasms, Myalgia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA09554

Write-up:Information has been received from a physician concerning a 14 year old female student who on 05-Oct-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653735/0688F). Concomitant therapy given at the same time in the same arm included a dose of hepatitis A virus vaccine (unspecified). On 06-Oct-2006, the patient experienced extremely severe cramping pain in arm at the vaccine site intermittently over about 16 hours following vaccination. The episodes lasted about 30 minutes each and were incapacitating. During the time between episodes the patient was completely pain free. The episodes continued through the night with the same intensity. The episodes stopped abruptly the next morning and there was no reoccurrence. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267436&WAYBACKHISTORY=ON


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