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This is VAERS ID 267479

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267479
Age:25.0
Gender:Female
Location:California
Vaccinated:2006-10-01
Onset:2006-10-01
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0689F / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Hives, food allergies.
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a certified medical assistant and a physician concerning a 25 year old female with a history of hives due to orange juice who in approximately Oct 2006, a couple of weeks ago, was vaccainted with a 0.5ml first dose of HP"V vaccine (lot 653736/0689F). There was no concomitant medication. Approximately 30 minutes after the vaccination, the pt experienced severe itching all over her body. It was reported that there was no rash. Unspecified medical attention was sought. Subse


Changed on 12/8/2009

VAERS ID: 267479 Before After
Age:25.0
Gender:Female
Location:California
Vaccinated:2006-10-01
Onset:2006-10-01
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. 0689F / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Hives, food allergies.
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0611USA00701

Write-up:Information has been received from a certified medical assistant and a physician concerning a 25 year old female with a history of hives due to orange juice who in approximately Oct 2006, a couple of weeks ago, was vaccainted with a 0.5ml first dose of HP"V HPV vaccine (lot 653736/0689F). There was no concomitant medication. Approximately 30 minutes after the vaccination, the pt experienced severe itching all over her body. It was reported that there was no rash. Unspecified medical attention was sought. Subse Subsequently, the pt recovered after approximately 2 days. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267479&WAYBACKHISTORY=ON


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