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This is VAERS ID 267467

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267467
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medica"l attention was sought. At the time of this report, the patient''''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

267467 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
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. - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type': (blank) WAES0610USA14848

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medica"l medical attention was sought. At the time of this report, the patient''''s patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 12/13/2013

267467 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type': WAES0610USA14848

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 6/14/2014

267467 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type': WAES0610USA14848

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 3/14/2015

267467 Before After
VAERS Form:
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type': WAES0610USA14848

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

267467 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:New York
Vaccinated:2006-10-26
Onset:2006-10-26
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blister, Oral mucosal blistering, Swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: UNK
CDC 'Split Type': WAES0610USA14848

Write-up:Information has been received from a physician concerning a female patient who on 26-OCT-2006 was vaccinated IM with a first dose of GARDASIL. On 26-OCT-2006 the patient experienced swelling as well as blisters in mouth and on the neck. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267467&WAYBACKHISTORY=ON


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