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This is VAERS ID 269190

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269190
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:2006-11-07
Onset:2006-11-07
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: Dizziness, Migraine

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Asthma, Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 15 year old female with asthma and penicillin allergy who on 26-Sep-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#not provided). Concomitant therapy inclu"ded hormonal contraceptives (unspecified). On 07-Nov-2006 the patient was vaccinated with the second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#6537361/0868F). That same day the patient experienced a migraine with a /"blinded spot in one eye/", d


Changed on 12/8/2009

269190 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:2006-11-07
Onset:2006-11-07
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: Dizziness, Migraine

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Asthma, Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0611USA03521

Write-up:Information has been received from a physician concerning a 15 year old female with asthma and penicillin allergy who on 26-Sep-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#not provided). Concomitant therapy inclu"ded included hormonal contraceptives (unspecified). On 07-Nov-2006 the patient was vaccinated with the second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#6537361/0868F). That same day the patient experienced a migraine with a /"blinded "blinded spot in one eye/", d eye", dizziness and was "seeing stars". She was treated with aspirin. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


Changed on 9/14/2017

269190 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:California
Vaccinated:2006-11-07
Onset:2006-11-07
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Migraine

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: CONCURRENT CONDITIONS: Asthma, Penicillin allergy
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0611USA03521

Write-up:Information has been received from a physician concerning a 15 year old female with asthma and penicillin allergy who on 26-Sep-2006 was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#not provided). Concomitant therapy included hormonal contraceptives (unspecified). On 07-Nov-2006 the patient was vaccinated with the second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot#6537361/0868F). That same day the patient experienced a migraine with a "blinded spot in one eye", dizziness and was "seeing stars". She was treated with aspirin. At the time of this report it was unknown if the patient had recovered from the event. Additional information has been requested.


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