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This is VAERS ID 269174

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269174
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0696F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature decreased, Headache, Nausea, Pain

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

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Conc"omitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-


Changed on 12/8/2009

VAERS ID: 269174 Before After
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
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. 0696F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Body temperature decreased, Headache, Nausea, Pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0611USA02205

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Conc"omitant Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov- 03-Nov-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 269174 Before After
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
Submitted:2006-12-14 2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0696F / 0 - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Body temperature decreased, Headache, Nausea, Pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA02205

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-2006, the next morning the patient had recovered from all of the events. 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 nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-NOV-2006 was vaccinated with the first dose of GARDASIL (Lot # 653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-NOV-2006 the patient developed nausea, dizziness, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-NOV-2006. On 03-NOV-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


Changed on 7/31/2010

VAERS ID: 269174 Before After
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0696F / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Headache, Nausea, Pain, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA02205

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-2006, the next morning the patient had recovered from all of the events. 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 nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-NOV-2006 was vaccinated with the first dose of GARDASIL (Lot # 653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-NOV-2006 the patient developed nausea, dizziness, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-NOV-2006. On 03-NOV-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 269174 Before After
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0696F / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Headache, Nausea, Pain, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA02205

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-2006, the next morning the patient had recovered from all of the events. 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 nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-NOV-2006 was vaccinated with the first dose of GARDASIL (Lot # 653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-NOV-2006 the patient developed nausea, dizziness, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-NOV-2006. On 03-NOV-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 269174 Before After
Age:19.0
Gender:Female
Location:Illinois
Vaccinated:2006-11-02
Onset:2006-11-02
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0696F / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Headache, Nausea, Pain, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: hormonal contraceptives
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA02205

Write-up:Information has been received from a nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-Nov-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-Nov-2006 the patient developed nausea, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-Nov-2006. On 03-Nov-2006, the next morning the patient had recovered from all of the events. 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 nurse concerning a 19 year old female patient who is the daughter of one of the office employees, who on 02-NOV-2006 was vaccinated with the first dose of GARDASIL (Lot # 653650/0696F). Concomitant therapy included hormonal contraceptives (unspecified). On 02-NOV-2006 the patient developed nausea, dizziness, low grade fever, achiness and a headache post vaccination. It was reported that these events continued into the evening on 02-NOV-2006. On 03-NOV-2006, the next morning the patient had recovered from all of the events. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269174&WAYBACKHISTORY=ON


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