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This is VAERS ID 269193

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269193
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2006-10-31
Onset:2006-10-31
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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 mother of an 11 year old female who on 31 Oct 2006 was vaccinated with Gardasil (yeast) (0.5 ml). On 31 Oct 2006, 30 minutes following vaccination, the patient''''s arm /"felt heavy/". Subsequently, the patient recovered"from the event 30 minutes later. Medical attention was not sought. Additional information has been requested.


Changed on 12/8/2009

269193 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2006-10-31
Onset:2006-10-31
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. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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) WAES0611USA04222

Write-up:Information has been received from a mother of an 11 year old female who on 31 Oct 2006 was vaccinated with Gardasil (yeast) (0.5 ml). On 31 Oct 2006, 30 minutes following vaccination, the patient''''s patient''s arm /"felt heavy/". "felt heavy". Subsequently, the patient recovered"from recovered from the event 30 minutes later. Medical attention was not sought. Additional information has been requested.


Changed on 9/14/2017

269193 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:New York
Vaccinated:2006-10-31
Onset:2006-10-31
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Sensation of heaviness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
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': WAES0611USA04222

Write-up:Information has been received from a mother of an 11 year old female who on 31 Oct 2006 was vaccinated with Gardasil (yeast) (0.5 ml). On 31 Oct 2006, 30 minutes following vaccination, the patient''s arm "felt heavy". Subsequently, the patient recovered from the event 30 minutes later. Medical attention was not sought. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269193&WAYBACKHISTORY=ON


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