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This is VAERS ID 267441

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267441
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0640F / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and t"he medication squirted /"out of the syringe/" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she w


Changed on 12/8/2009

267441 Before After
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
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. 0640F / - UN / -

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and t"he the medication squirted /"out "out of the syringe/" syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she w was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested.


Changed on 2/5/2010

267441 Before After
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Erythema

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and the medication squirted "out of the syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested. It was reported that the patient who was scheduled to received HPV came back the next week and received a dose of HPV which was not in a prefilled syringe, without any problems. The patient had no side effects. Additional information has been requested.


Changed on 7/31/2010

267441 Before After
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Accidental exposure, Burning sensation, Erythema, Skin warm, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and the medication squirted "out of the syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested. It was reported that the patient who was scheduled to received HPV came back the next week and received a dose of HPV which was not in a prefilled syringe, without any problems. The patient had no side effects. Additional information has been requested.


Changed on 6/14/2014

267441 Before After
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Accidental exposure, Burning sensation, Erythema, Skin warm, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and the medication squirted "out of the syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested. It was reported that the patient who was scheduled to received HPV came back the next week and received a dose of HPV which was not in a prefilled syringe, without any problems. The patient had no side effects. Additional information has been requested.


Changed on 5/14/2017

267441 Before After
VAERS Form:
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / - UN / -

Administered by: Other      Purchased by: Other
Symptoms: Accidental exposure, Burning sensation, Erythema, Skin warm, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and the medication squirted "out of the syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested. It was reported that the patient who was scheduled to received HPV came back the next week and received a dose of HPV which was not in a prefilled syringe, without any problems. The patient had no side effects. Additional information has been requested.


Changed on 9/14/2017

267441 Before After
VAERS Form:(blank) 1
Age:42.0
Gender:Female
Location:Oklahoma
Vaccinated:2006-10-18
Onset:2006-10-18
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0640F / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Accidental exposure, Burning sensation, Erythema, Skin warm, Medical device complication

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: LORTAB, WELLBUTRIN SR, BIAXIN, trazodone hydrochloride
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11279

Write-up:Information has been received from an office manager and a 42 year old female medical assistant with a Penicillin allergy who on 18-Oct-2006 went to place the needle on the HPV rL1 6 11 16 18 VLP vaccine (yeast0 (Lot#653650/0640F) pre-filled syringe and the medication squirted "out of the syringe" into the air. Concomitant therapy included bupropion HCl (WELLBUTRIN SR), Clarithromycin (BIAXIN), acetaminophen/hydrocodone bitartrate (LORTAB) and Trazodone HCl. The medication did get on her hands and she was experiencing burning and had redness on her index finger. It was warm to touch. At the time of this report, the patient was recovering from the events and the redness was decreasing. Additional information has been requested. It was reported that the patient who was scheduled to received HPV came back the next week and received a dose of HPV which was not in a prefilled syringe, without any problems. The patient had no side effects. Additional information has been requested.


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