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This is VAERS ID 269204

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269204
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
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: Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female who on 08 Nove 2006 was vaccinated intramuscularly with the first dose of Gardasil (yeast) (Lot # not provided). On 09 Nov 2006 it was reported that the patient developed hives". Unspecified medical attention was sought. At the time of this report it was unknown if the patient had recovered. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 269204 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
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: Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0611USA04681

Write-up:Information has been received from a physician concerning a 16 year old female who on 08 Nove 2006 was vaccinated intramuscularly with the first dose of Gardasil (yeast) (Lot # not provided). On 09 Nov 2006 it was reported that the patient developed hives". hives. Unspecified medical attention was sought. At the time of this report it was unknown if the patient had recovered. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269204&WAYBACKHISTORY=ON


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