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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 269166 |
VAERS Form: | |
Age: | 24.0 |
Sex: | Female |
Location: | Texas |
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. | - / 0 | - / - |
Administered by: Other Purchased by: Unknown
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications"reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy /"this developed about 13 da
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
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. | - / 0 | - / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications"reported. medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy /"this "this developed about 13 da days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 0 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Vaccinated: | 2006-10-19 |
Onset: | 2006-10-19 |
Submitted: | 2006-12-14 |
Entered: | 2006-12-18 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / 1 | - / - |
Administered by: Other Purchased by: Other
Symptoms: Injection site mass, Pruritus
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA01331
Write-up: Information has been received from a medical assistant concerning a 24 year old female with no other relevant history reported. On 19 Oct 2006, the patient was vaccinated with the first dose of Gardasil (yeast). There were no other concomitant medications reported. On 19 Oct 2006, the patient developed some initial itching at the injection site that resolved (date unknown). On 02 Nov 2006, the patient reported that she awoke with a large red bump at the injection that was itchy "this developed about 13 days post dose". The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269166&WAYBACKHISTORY=ON
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