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This is VAERS ID 269167

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269167
VAERS Form:
Age:12.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-30
Onset:2006-10-01
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 - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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 nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as /"oral/". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought uns"pecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested.


Changed on 12/8/2009

269167 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-30
Onset:2006-10-01
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 - / PO

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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) WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as /"oral/". "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought uns"pecified unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested.


Changed on 1/5/2010

269167 Before After
VAERS Form:
Age:12.0 15.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-30 2006-10-04
Onset:2006-10-01 2006-10-04
Submitted:2006-12-14 2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0800F / 0 - / PO

Administered by: Other Private      Purchased by: Other
Symptoms: Pruritus genital

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 7/31/2010

269167 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 8/31/2010

269167 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Pruritus genital, Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 1/4/2011

269167 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Pruritus genital, Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 6/14/2014

269167 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 5/14/2017

269167 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / PO

Administered by: Private      Purchased by: Other
Symptoms: Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


Changed on 9/14/2017

269167 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-04
Onset:2006-10-04
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 1 - MO / PO

Administered by: Private      Purchased by: Other
Symptoms: Vulvovaginal pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness: Asthma
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01335

Write-up:Information has been received from a nurse concerning a 12 year old female who on 30 Seo 2006 was vaccinated with the first 0.5 mL dose of Gardasil reported as "oral". On 01 Oct 2006, the patient developed intense vaginal itching. The patient sought unspecified medical attention. On 03 Oct 2006, the patient recovered from the event. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Information has been received from a medical assistant (previously reported as a nurse) concerning a 15 year old female student (previously reported as a 12 year old) with asthma. On 04-OCT-2006, at 4:30 PM, (previously reported as 30-SEP-2006), the patient was vaccinated in the left deltoid with the first 0.5 mL dose of GARDASIL (Lot # 654540/0800F). There were no illnesses noted at the time of vaccination. On 04-OCT-2006 (previously reported as 01-OCT-2006), at 6:30 PM, the patient developed intense vaginal itching which continued to the day after. It was reported then it stopped abruptly on Day# 3. On 06-OCT-2006, the patient had recovered from the event. Additional information has been requested.


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