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This is VAERS ID 269186

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269186
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL, LEXAPRO, CLARITIN
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Depression, Anxiety, Penicillin allergy, Sulfonamide allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning an 18 year old female with low level depression and anxiety and penicillin allergy and sulfonamide allergy who on 30-Oct-2006 was vaccinated intramuscularly in the right deltoid with the f"irst dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653978/0955F). Concomitant therapy included escitalopram oxalate (LEXAPRO), loratadine (CLARITIN) acetaminophen (TYLENOL). On 30-Oct-2006, following vaccination, the patient fainted. Unspecified med


Changed on 12/8/2009

VAERS ID: 269186 Before After
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2006-10-30
Onset:2006-10-30
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. 0955F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Loss of consciousness

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: TYLENOL, LEXAPRO, CLARITIN
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Depression, Anxiety, Penicillin allergy, Sulfonamide allergy
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0611USA03446

Write-up:Information has been received from a nurse practitioner concerning an 18 year old female with low level depression and anxiety and penicillin allergy and sulfonamide allergy who on 30-Oct-2006 was vaccinated intramuscularly in the right deltoid with the f"irst first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653978/0955F). Concomitant therapy included escitalopram oxalate (LEXAPRO), loratadine (CLARITIN) acetaminophen (TYLENOL). On 30-Oct-2006, following vaccination, the patient fainted. Unspecified med medical attention was sought. Subsequently, the patient recovered and no other symptoms were noted. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269186&WAYBACKHISTORY=ON


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