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This is VAERS ID 269211

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269211
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2006-11-14
Onset:2006-11-15
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Euphoric mood, Malaise, Nausea, Abnormal behaviour

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 13 year old female with a penicillin allergy and drug hypersensitivity to Zithromax. On 14 Nov 2006, the patient was vaccinated with Gardasil (yeast) ( Lot # 653978/0955F). There were no c"oncomitant medications reported. On 15 Nov 2006, the patient was noted to be very emotional, nauseated, felt dazed and /"high/". The patient sought unspecified medical attention. No treatment was required. On 16 Nov 2006, the patient had recovered from th


Changed on 12/8/2009

VAERS ID: 269211 Before After
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2006-11-14
Onset:2006-11-15
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. 0955F / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Euphoric mood, Malaise, Nausea, Abnormal behaviour

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0611USA05160

Write-up:Information has been received from a registered nurse concerning a 13 year old female with a penicillin allergy and drug hypersensitivity to Zithromax. On 14 Nov 2006, the patient was vaccinated with Gardasil (yeast) ( Lot # 653978/0955F). There were no c"oncomitant concomitant medications reported. On 15 Nov 2006, the patient was noted to be very emotional, nauseated, felt dazed and /"high/". "high". The patient sought unspecified medical attention. No treatment was required. On 16 Nov 2006, the patient had recovered from th the events. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 269211 Before After
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2006-11-14
Onset:2006-11-15
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - / -

Administered by: Other Private      Purchased by: Other
Symptoms: Euphoric mood, Malaise, Nausea, Abnormal behaviour

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA05160

Write-up:Information has been received from a registered nurse concerning a 13 year old female with a penicillin allergy and drug hypersensitivity to Zithromax. On 14 Nov 2006, the patient was vaccinated with Gardasil (yeast) ( Lot # 653978/0955F). There were no concomitant medications reported. On 15 Nov 2006, the patient was noted to be very emotional, nauseated, felt dazed and "high". The patient sought unspecified medical attention. No treatment was required. On 16 Nov 2006, the patient had recovered from the events. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 269211 Before After
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2006-11-14
Onset:2006-11-15
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Euphoric mood, Malaise, Nausea, Abnormal behaviour

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA05160

Write-up:Information has been received from a registered nurse concerning a 13 year old female with a penicillin allergy and drug hypersensitivity to Zithromax. On 14 Nov 2006, the patient was vaccinated with Gardasil (yeast) ( Lot # 653978/0955F). There were no concomitant medications reported. On 15 Nov 2006, the patient was noted to be very emotional, nauseated, felt dazed and "high". The patient sought unspecified medical attention. No treatment was required. On 16 Nov 2006, the patient had recovered from the events. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 269211 Before After
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2006-11-14
Onset:2006-11-15
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - / -

Administered by: Private      Purchased by: Other
Symptoms: Euphoric mood, Malaise, Nausea, Abnormal behaviour

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Penicillin allergy, drug hypersensitivity
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0611USA05160

Write-up:Information has been received from a registered nurse concerning a 13 year old female with a penicillin allergy and drug hypersensitivity to Zithromax. On 14 Nov 2006, the patient was vaccinated with Gardasil (yeast) ( Lot # 653978/0955F). There were no concomitant medications reported. On 15 Nov 2006, the patient was noted to be very emotional, nauseated, felt dazed and "high". The patient sought unspecified medical attention. No treatment was required. On 16 Nov 2006, the patient had recovered from the events. Additional information has been requested.


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