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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
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
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
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
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.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267452&WAYBACKHISTORY=ON


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