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This is VAERS ID 267480

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267480
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2006-08-31
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. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Viral infection

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: Pap Test
CDC 'Split Type':

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unsp"ecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At


Changed on 12/8/2009

267480 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2006-08-31
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. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Viral infection

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: Pap Test
CDC 'Split Type': (blank) WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unsp"ecified unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested.


Changed on 1/5/2010

267480 Before After
VAERS Form:
Age:15.0 16.0
Gender:Female
Location:Unknown Oregon
Vaccinated:2006-08-31 2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other Private      Purchased by: Other Private
Symptoms: Viral infection

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 7/31/2010

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 8/31/2010

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Viral infection, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 1/4/2011

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Viral infection, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 3/14/2014

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / - UN

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 6/14/2014

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 3/14/2015

267480 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


Changed on 9/14/2017

267480 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2006-08-24
Onset:0000-00-00
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Smear cervix, Human papilloma virus test positive

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: Migraine
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Pap Test
CDC 'Split Type': WAES0611USA00721

Write-up:Information has been received from a licensed practical nurse concerning a 15 year old female with migraines and no known allergies or adverse drug reactions reported. On approx 8/31/06, the pt was vaccinated with the first dose of HPV vaccine. On an unspecified date, the pt was noted to be positive for an unknown number of high risk human papilloma virus types. The pt underwent a pap test (date and results not reported). The pt sought unspecified medical attention. a colposcopy was planned for the pt. At the time of this report, the pt had not recovered from the event. Additional information has been requested. This is in follow-up to report(s) previously submitted on 11/14/2006. Information has been received from a licensed practical nurse concerning a 16 year old female subject with migraines and no known allergies or adverse drug reactions reported. On 24-AUG-2006, the patient was vaccinated with the first dose of GARDASIL. On an unspecified date, the patient was noted to be positive for an unknown number of high risk human papilloma virus types. The patient underwent a PAP (date and results not reported). The patient sought unspecified medical attention. A colposcopy was planned for the patient. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


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