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This is VAERS ID 269249

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269249
Age:25.0
Gender:Female
Location:Michigan
Vaccinated:2006-11-03
Onset:2006-11-29
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0868F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Discomfort, Lymphadenopathy, Malaise, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: penicillin allergy
Diagnostic Lab Data: complete blood cell /"normal/"; throat culture /"results pending/"
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 24 year old female with a penicillin allergy and had no other pertinent medical history reported. On 03 Nov 2006, the patient was vaccinated intramuscularly in the right deltoid with a 0.5"mL of Gardasil vaccine (yeast) (Lot # 653736/0868F). There were no concomitant medications reported. On 29 Nov 2006, the patient was examined by the physician and was complaining of swelling of the right cervical lymph node and low grade fever. The physic


Changed on 12/8/2009

VAERS ID: 269249 Before After
Age:25.0
Gender:Female
Location:Michigan
Vaccinated:2006-11-03
Onset:2006-11-29
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. 0868F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Discomfort, Lymphadenopathy, Malaise, Pyrexia

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: penicillin allergy
Diagnostic Lab Data: complete blood cell /"normal/"; "normal"; throat culture /"results pending/" "results pending"
CDC 'Split Type': (blank) WAES0612USA00311

Write-up:Information has been received from a registered nurse concerning a 24 year old female with a penicillin allergy and had no other pertinent medical history reported. On 03 Nov 2006, the patient was vaccinated intramuscularly in the right deltoid with a 0.5"mL 0.5 mL of Gardasil vaccine (yeast) (Lot # 653736/0868F). There were no concomitant medications reported. On 29 Nov 2006, the patient was examined by the physician and was complaining of swelling of the right cervical lymph node and low grade fever. The physic physician ordered a complete blood count (CBC), which was normal. On 30 Nov 2006, the patient was re-examinined and the right cervical lymph node had increased in size and the patient had developed swelling of the right axillary lymph nodes, peri-sternal discomfort and extreme malaise. The physician ordered a throat culture and results were pending. The patient was being referred to her internist for follow up. Unspecified medical attention was sought. At the time of this report, the patient had not recovered from the events. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269249&WAYBACKHISTORY=ON


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