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This is VAERS ID 269213

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269213
VAERS Form:
Age:25.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Viral infection

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Positive HPV test
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 25 year old female who on an unspecified date was vaccinated with HPV Vaccine. One week later, the patient was noted to have a positive human papilloma virus infection (date unknown). It was repo"rted that the physician dose not know when the vaccine was given or the dose because she did not administer the vaccine in her office. The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the eve


Changed on 12/8/2009

269213 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
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. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Viral infection

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Positive HPV test
CDC 'Split Type': (blank) WAES0611USA05651

Write-up:Information has been received from a physician concerning a 25 year old female who on an unspecified date was vaccinated with HPV Vaccine. One week later, the patient was noted to have a positive human papilloma virus infection (date unknown). It was repo"rted reported that the physician dose not know when the vaccine was given or the dose because she did not administer the vaccine in her office. The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the eve event. Additional information has been requested.


Changed on 9/14/2017

269213 Before After
VAERS Form:(blank) 1
Age:25.0
Gender:Female
Location:California
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Viral infection

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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: Positive HPV test
CDC 'Split Type': WAES0611USA05651

Write-up:Information has been received from a physician concerning a 25 year old female who on an unspecified date was vaccinated with HPV Vaccine. One week later, the patient was noted to have a positive human papilloma virus infection (date unknown). It was reported that the physician dose not know when the vaccine was given or the dose because she did not administer the vaccine in her office. The patient sought unspecified medical attention. At the time of this report, the patient had not recovered from the event. Additional information has been requested.


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