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This is VAERS ID 269230

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269230
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-11-16
Onset:2006-11-26
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a penicillin allergy who on 16 Nov 2006 was vaccainted with a first 0.5ml dose of HPV vaccine. Concomitant therapy included LOESTRIM. On 26 Nov 2006 the patient b"roke out into hives. The patient was treated with a steroid and was doing fine. No product quality complaint was involved. Additional information has been requested.


Changed on 12/8/2009

269230 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-11-16
Onset:2006-11-26
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. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0611USA07518

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a penicillin allergy who on 16 Nov 2006 was vaccainted with a first 0.5ml dose of HPV vaccine. Concomitant therapy included LOESTRIM. On 26 Nov 2006 the patient b"roke broke out into hives. The patient was treated with a steroid and was doing fine. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

269230 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-11-16
Onset:2006-11-26
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Loestrin
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA07518

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a penicillin allergy who on 16 Nov 2006 was vaccainted with a first 0.5ml dose of HPV vaccine. Concomitant therapy included LOESTRIM. On 26 Nov 2006 the patient broke out into hives. The patient was treated with a steroid and was doing fine. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269230&WAYBACKHISTORY=ON


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