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This is VAERS ID 269184

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269184
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-11-02
Onset:2006-11-09
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: Erythema, Injection site pain, Swelling

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 physician concerning an approximately 18 year old female who on approximately 02-Nov-2006 was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On week after vaccination, on appr"oximately 09-Nov-2006, the patient experienced pain at the injection site, and had redness, soreness and swelling. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional information has been


Changed on 12/8/2009

269184 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-11-02
Onset:2006-11-09
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: Erythema, Injection site pain, Swelling

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) WAES0611USA03416

Write-up:Information has been received from a physician concerning an approximately 18 year old female who on approximately 02-Nov-2006 was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On week after vaccination, on appr"oximately approximately 09-Nov-2006, the patient experienced pain at the injection site, and had redness, soreness and swelling. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional information has been requested.


Changed on 9/14/2017

269184 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-11-02
Onset:2006-11-09
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: Erythema, Injection site pain, Swelling

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': WAES0611USA03416

Write-up:Information has been received from a physician concerning an approximately 18 year old female who on approximately 02-Nov-2006 was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On week after vaccination, on approximately 09-Nov-2006, the patient experienced pain at the injection site, and had redness, soreness and swelling. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269184&WAYBACKHISTORY=ON


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