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This is VAERS ID 267438

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267438
Age:22.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-09
Onset:2006-10-16
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site mass, Injection site warmth

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Hypertension; General symptom
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a 22 year old female with hypertension and /"an interstitial problem/" NOS who on 09-Oct-2006 was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided"). Concomitant therapy included unspecified therapy. On 16-Oct-2006 the patient developed a /"quarter size knot at the injection site that was warm to touch/". Medical attention was sought and the patient was treated with diphenhydramine hydrochloride (B


Changed on 12/8/2009

VAERS ID: 267438 Before After
Age:22.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-09
Onset:2006-10-16
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. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site mass, Injection site warmth

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Hypertension; General symptom
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0610USA10767

Write-up:Information has been received from a health professional concerning a 22 year old female with hypertension and /"an "an interstitial problem/" problem" NOS who on 09-Oct-2006 was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided"). provided). Concomitant therapy included unspecified therapy. On 16-Oct-2006 the patient developed a /"quarter "quarter size knot at the injection site that was warm to touch/". touch". Medical attention was sought and the patient was treated with diphenhydramine hydrochloride (B (BENADRYL). It was reported that the patient will discontinue the vaccination series. At the time of this report the patient had not recovered from the event. Additional information has been requested.


Changed on 3/14/2014

VAERS ID: 267438 Before After
Age:22.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-09
Onset:2006-10-16
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site warmth

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Hypertension; General symptom
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10767

Write-up:Information has been received from a health professional concerning a 22 year old female with hypertension and "an interstitial problem" NOS who on 09-Oct-2006 was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Concomitant therapy included unspecified therapy. On 16-Oct-2006 the patient developed a "quarter size knot at the injection site that was warm to touch". Medical attention was sought and the patient was treated with diphenhydramine hydrochloride (BENADRYL). It was reported that the patient will discontinue the vaccination series. At the time of this report the patient had not recovered from the event. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 267438 Before After
Age:22.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-09
Onset:2006-10-16
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site warmth

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Hypertension; General symptom
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10767

Write-up:Information has been received from a health professional concerning a 22 year old female with hypertension and "an interstitial problem" NOS who on 09-Oct-2006 was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Concomitant therapy included unspecified therapy. On 16-Oct-2006 the patient developed a "quarter size knot at the injection site that was warm to touch". Medical attention was sought and the patient was treated with diphenhydramine hydrochloride (BENADRYL). It was reported that the patient will discontinue the vaccination series. At the time of this report the patient had not recovered from the event. Additional information has been requested.


Changed on 3/14/2015

VAERS ID: 267438 Before After
Age:22.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-09
Onset:2006-10-16
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site mass, Injection site warmth

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: (therapy unspecified)
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Hypertension; General symptom
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA10767

Write-up:Information has been received from a health professional concerning a 22 year old female with hypertension and "an interstitial problem" NOS who on 09-Oct-2006 was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Concomitant therapy included unspecified therapy. On 16-Oct-2006 the patient developed a "quarter size knot at the injection site that was warm to touch". Medical attention was sought and the patient was treated with diphenhydramine hydrochloride (BENADRYL). It was reported that the patient will discontinue the vaccination series. At the time of this report the patient had not recovered from the event. Additional information has been requested.


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