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This is VAERS ID 267452

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267452
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-16
Onset:2006-10-17
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Nausea, Pyrexia

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

Write-up: Information has been received from a physician concerning a 15 year old female who on 10/16/06 was vaccinated with an IM HVP vaccine (lot 653978/0955F). On 10/17/06 the pt was sent home from school because she developed a fever of 102F and nausea. the phy"sician reported that after 12 hours the pt recovered and returned to school the next day symptoms free. Additional information is not expected.


Changed on 12/8/2009

VAERS ID: 267452 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-16
Onset:2006-10-17
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. 0955F / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0610USA12445

Write-up: Information has been received from a physician concerning a 15 year old female who on 10/16/06 was vaccinated with an IM HVP vaccine (lot 653978/0955F). On 10/17/06 the pt was sent home from school because she developed a fever of 102F and nausea. the phy"sician physician reported that after 12 hours the pt recovered and returned to school the next day symptoms free. Additional information is not expected.


Changed on 9/14/2017

VAERS ID: 267452 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-16
Onset:2006-10-17
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA12445

Write-up: Information has been received from a physician concerning a 15 year old female who on 10/16/06 was vaccinated with an IM HVP vaccine (lot 653978/0955F). On 10/17/06 the pt was sent home from school because she developed a fever of 102F and nausea. the physician reported that after 12 hours the pt recovered and returned to school the next day symptoms free. Additional information is not expected.


Changed on 2/14/2018

VAERS ID: 267452 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-16
Onset:2006-10-17
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Nausea, Pyrexia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0610USA12445

Write-up: Information has been received from a physician concerning a 15 year old female who on 10/16/06 was vaccinated with an IM HVP vaccine (lot 653978/0955F). On 10/17/06 the pt was sent home from school because she developed a fever of 102F and nausea. the physician reported that after 12 hours the pt recovered and returned to school the next day symptoms free. Additional information is not expected.


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