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This is VAERS ID 269169

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269169
VAERS Form:
Age:
Gender:Female
Location:Illinois
Vaccinated:2006-09-21
Onset:2006-09-21
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 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Oedema peripheral, Urticaria

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: UNK
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a her 19 to 21 year old daughter who on approximately 21 Sep 2006 /"about 6 weeks ago/" was vaccinated IM with a first dose of Gardasil (yeast). Within 5 to 6 hours of vaccination, the pa"tient developed hives and swelling of her hands and feet. The patient was given (Benadryl) and the symptoms began to heal. Subsequently, the patient recovering. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

269169 Before After
VAERS Form:
Age:
Gender:Female
Location:Illinois
Vaccinated:2006-09-21
Onset:2006-09-21
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 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Oedema peripheral, Urticaria

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: UNK
CDC 'Split Type': (blank) WAES0611USA01393

Write-up:Information has been received from a health professional concerning a her 19 to 21 year old daughter who on approximately 21 Sep 2006 /"about "about 6 weeks ago/" ago" was vaccinated IM with a first dose of Gardasil (yeast). Within 5 to 6 hours of vaccination, the pa"tient patient developed hives and swelling of her hands and feet. The patient was given (Benadryl) and the symptoms began to heal. Subsequently, the patient recovering. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

269169 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Illinois
Vaccinated:2006-09-21
Onset:2006-09-21
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Oedema peripheral, Urticaria

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: UNK
CDC 'Split Type': WAES0611USA01393

Write-up:Information has been received from a health professional concerning a her 19 to 21 year old daughter who on approximately 21 Sep 2006 "about 6 weeks ago" was vaccinated IM with a first dose of Gardasil (yeast). Within 5 to 6 hours of vaccination, the patient developed hives and swelling of her hands and feet. The patient was given (Benadryl) and the symptoms began to heal. Subsequently, the patient recovering. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269169&WAYBACKHISTORY=ON


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