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This is VAERS ID 269171

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269171
Age:
Gender:Female
Location:Indiana
Vaccinated:2006-11-02
Onset:2006-11-03
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Arthralgia, Rash

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

Write-up:Information has been received from a physician concerning a female who on an unspecified date received the first dose of Gardasil (yeast) (Lot # not provided). On 02 Nov 2006 the patient was vaccinated with the second dose of Gardasil (yeast) (Lot # not p"rovided). On 03 Nov 2006 the patient experienced joint pain and developed a rash. Unspecified medical attention was sought. At the time of this report the patient was recovering from the event. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 269171 Before After
Age:
Gender:Female
Location:Indiana
Vaccinated:2006-11-02
Onset:2006-11-03
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. - / 1 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthralgia, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0611USA01551

Write-up:Information has been received from a physician concerning a female who on an unspecified date received the first dose of Gardasil (yeast) (Lot # not provided). On 02 Nov 2006 the patient was vaccinated with the second dose of Gardasil (yeast) (Lot # not p"rovided). provided). On 03 Nov 2006 the patient experienced joint pain and developed a rash. Unspecified medical attention was sought. At the time of this report the patient was recovering from the event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269171&WAYBACKHISTORY=ON


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