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This is VAERS ID 269189

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269189
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0800F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Anxiety, Hyperhidrosis, Injection site erythema, Lymphadenopathy, Injection site 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: CONCURRENT CONDITIONS: Anxiety
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Information has been received from a physician concerning his daughter, a 19 year old female who at 15:00 on 08-Nov-2006 /"was feeling great anxiety/" before receiving an intramuscular injection with the vaccination HPV rL1 6 11 16 18 VLP vaccine (yeast)"(Lot#654540/0800F). On 08-Nov-2006 after receiving the vaccination the patient experienced throbbing pain, a tingling sensation down length of her arm, elbow, wrist, jaw line and down her neck, fever, swelling and redness at the injection site, was /"terr


Changed on 12/8/2009

VAERS ID: 269189 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-08
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. 0800F / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Anxiety, Hyperhidrosis, Injection site erythema, Lymphadenopathy, Nausea, Pain, Paraesthesia, Pruritus, Pyrexia, Injection site 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: CONCURRENT CONDITIONS: Anxiety
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0611USA03485

Write-up: Information has been received from a physician concerning his daughter, a 19 year old female who at 15:00 on 08-Nov-2006 /"was "was feeling great anxiety/" anxiety" before receiving an intramuscular injection with the vaccination HPV rL1 6 11 16 18 VLP vaccine (yeast)"(Lot#654540/0800F). (yeast) (Lot#654540/0800F). On 08-Nov-2006 after receiving the vaccination the patient experienced throbbing pain, a tingling sensation down length of her arm, elbow, wrist, jaw line and down her neck, fever, swelling and redness at the injection site, was /"terr "terribly itchy", had veins protruding, swollen glands, nausea and "felt hot and sweaty" (the patient was reported to be afebrile). Unspecified medical attention was sought. At the time of the report it was unknown if the patient had recovered. Additional information is not expected.


Changed on 9/14/2017

VAERS ID: 269189 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Anxiety, Hyperhidrosis, Injection site erythema, Lymphadenopathy, Nausea, Pain, Paraesthesia, Pruritus, Pyrexia, Injection site 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: CONCURRENT CONDITIONS: Anxiety
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA03485

Write-up: Information has been received from a physician concerning his daughter, a 19 year old female who at 15:00 on 08-Nov-2006 "was feeling great anxiety" before receiving an intramuscular injection with the vaccination HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#654540/0800F). On 08-Nov-2006 after receiving the vaccination the patient experienced throbbing pain, a tingling sensation down length of her arm, elbow, wrist, jaw line and down her neck, fever, swelling and redness at the injection site, was "terribly itchy", had veins protruding, swollen glands, nausea and "felt hot and sweaty" (the patient was reported to be afebrile). Unspecified medical attention was sought. At the time of the report it was unknown if the patient had recovered. Additional information is not expected.


Changed on 2/14/2018

VAERS ID: 269189 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Anxiety, Hyperhidrosis, Injection site erythema, Lymphadenopathy, Nausea, Pain, Paraesthesia, Pruritus, Pyrexia, Injection site 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: CONCURRENT CONDITIONS: Anxiety
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA03485

Write-up: Information has been received from a physician concerning his daughter, a 19 year old female who at 15:00 on 08-Nov-2006 "was feeling great anxiety" before receiving an intramuscular injection with the vaccination HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#654540/0800F). On 08-Nov-2006 after receiving the vaccination the patient experienced throbbing pain, a tingling sensation down length of her arm, elbow, wrist, jaw line and down her neck, fever, swelling and redness at the injection site, was "terribly itchy", had veins protruding, swollen glands, nausea and "felt hot and sweaty" (the patient was reported to be afebrile). Unspecified medical attention was sought. At the time of the report it was unknown if the patient had recovered. Additional information is not expected.


Changed on 6/14/2018

VAERS ID: 269189 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Anxiety, Hyperhidrosis, Injection site erythema, Lymphadenopathy, Nausea, Pain, Paraesthesia, Pruritus, Pyrexia, Injection site 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: CONCURRENT CONDITIONS: Anxiety
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA03485

Write-up: Information has been received from a physician concerning his daughter, a 19 year old female who at 15:00 on 08-Nov-2006 "was feeling great anxiety" before receiving an intramuscular injection with the vaccination HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#654540/0800F). On 08-Nov-2006 after receiving the vaccination the patient experienced throbbing pain, a tingling sensation down length of her arm, elbow, wrist, jaw line and down her neck, fever, swelling and redness at the injection site, was "terribly itchy", had veins protruding, swollen glands, nausea and "felt hot and sweaty" (the patient was reported to be afebrile). Unspecified medical attention was sought. At the time of the report it was unknown if the patient had recovered. Additional information is not expected.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269189&WAYBACKHISTORY=ON


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