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This is VAERS ID 267447

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267447
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Influenza like illness, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV vaccine (it was reported that it was uncertain whether this was the pts first dose). Subsequently, the day after vaccination, the pt ex"perienced flu-like symptoms, felt horrible and felt very sick for a few days. At the time of this report, the pt had no more flu-like symptoms. Additional information has been requested.


Changed on 12/8/2009

267447 Before After
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
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. - / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Influenza like illness, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA11954

Write-up:Information has been received from a nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV vaccine (it was reported that it was uncertain whether this was the pts first dose). Subsequently, the day after vaccination, the pt ex"perienced experienced flu-like symptoms, felt horrible and felt very sick for a few days. At the time of this report, the pt had no more flu-like symptoms. Additional information has been requested.


Changed on 6/14/2014

267447 Before After
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
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: Influenza like illness, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11954

Write-up:Information has been received from a nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV vaccine (it was reported that it was uncertain whether this was the pts first dose). Subsequently, the day after vaccination, the pt experienced flu-like symptoms, felt horrible and felt very sick for a few days. At the time of this report, the pt had no more flu-like symptoms. Additional information has been requested.


Changed on 3/14/2015

267447 Before After
VAERS Form:
Age:
Gender:Female
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
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: Influenza like illness, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11954

Write-up:Information has been received from a nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV vaccine (it was reported that it was uncertain whether this was the pts first dose). Subsequently, the day after vaccination, the pt experienced flu-like symptoms, felt horrible and felt very sick for a few days. At the time of this report, the pt had no more flu-like symptoms. Additional information has been requested.


Changed on 9/14/2017

267447 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Connecticut
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Influenza like illness, Malaise

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0610USA11954

Write-up:Information has been received from a nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV vaccine (it was reported that it was uncertain whether this was the pts first dose). Subsequently, the day after vaccination, the pt experienced flu-like symptoms, felt horrible and felt very sick for a few days. At the time of this report, the pt had no more flu-like symptoms. Additional information has been requested.


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