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This is VAERS ID 269205

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269205
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Oedema peripheral, Pruritus, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscular"ly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms we


Changed on 12/8/2009

269205 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
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. 0689F / 0 - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Oedema peripheral, Pruritus, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscular"ly intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms we were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested.


Changed on 1/5/2010

269205 Before After
VAERS Form:
Age:23.0 22.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2006-12-14 2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private      Purchased by: Other Private
Symptoms: Oedema peripheral, Pruritus, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: UNK None
CDC 'Split Type': WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


Changed on 7/31/2010

269205 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Oedema peripheral, Pruritus, Rash generalised, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


Changed on 6/14/2014

269205 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Oedema peripheral, Pruritus, Rash generalised, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


Changed on 5/14/2017

269205 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Oedema peripheral, Pruritus, Rash generalised, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


Changed on 9/14/2017

269205 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:Illinois
Vaccinated:2006-09-26
Onset:2006-09-26
Submitted:2007-04-06
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Oedema peripheral, Pruritus, Rash generalised, Urticaria

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: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0611USA04701

Write-up:Information has been received from a registered nurse concerning a 22 year ld white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26 Sep 2006, at 12:300 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (yeast) (Lot# 653736/0689F), within 2 hours of the injections the patient developed full body hives, itching and swelling of hands and feet. The patient took Benadryl every 4 hours and the symptoms were gone within 24 hours. At the time of this report, the patient had recovered from the events. Additional information has been requested. This is in follow-up to report(s) previously submitted on 12/14/2006. Initial and follow up information has been received from a registered nurse concerning a 23 year old (previously reported as 22 year old) white female student with no other medical history, no known allergies or adverse drug reactions reported. On 26-SEP-2006, at 3:00 PM, the patient was vaccinated intramuscularly in the left deltoid with the first dose of GARDASIL (Lot # 653736/0689F). There were no illnesses noted at the time of vaccination. On 26-SEP-2006, at 4:00 PM, the patient developed a rash over body (previously) reported as full body hives and had itching) and had swelling of hands and feet. The patient took BENADRYL every 4 hours and the rash was gone within 24 hours. On 27-SEP-2006, the patient had recovered from the events. Additional information has been requested.


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