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This is VAERS ID 269164

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269164
Age:48.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-31
Onset:2006-10-31
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site induration, Haemorrhage

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin
Current Illness:
Preexisting Conditions: Condyloma, dysplasia
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning an approximately 48 year old female patient with condyloma with mild to moderate dysplasia who on 31 Oct 2006 was vaccinated IM into the deltoid with a second 0.5mL dose of Gardasil (yeas"t) (lot # 653978/0955F). Concomitant therapy included aspirin. It was reported that after the nurse gave the injection blood immediately ran out of the site and it was hard and lumpy. It was reported that the nurse used proper placement technique and a st


Changed on 12/8/2009

VAERS ID: 269164 Before After
Age:48.0
Gender:Female
Location:Unknown
Vaccinated:2006-10-31
Onset:2006-10-31
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site induration, Haemorrhage

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: aspirin
Current Illness:
Preexisting Conditions: Condyloma, dysplasia
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0611USA00994

Write-up:Information has been received from a health professional concerning an approximately 48 year old female patient with condyloma with mild to moderate dysplasia who on 31 Oct 2006 was vaccinated IM into the deltoid with a second 0.5mL dose of Gardasil (yeas"t) (yeast) (lot # 653978/0955F). Concomitant therapy included aspirin. It was reported that after the nurse gave the injection blood immediately ran out of the site and it was hard and lumpy. It was reported that the nurse used proper placement technique and a st standard 1 inch needle (not the prefilled device). The patient had no problems with the first dose. The patient did not report any discomfort from the hard and lumpy area. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269164&WAYBACKHISTORY=ON


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