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This is VAERS ID 269255

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269255
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
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. - / 1 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Arthralgia

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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a nurse in a physician''''s office concerning a 15 year old female who in approximately September 2006, was vaccinated with the second 0.5 mL dose of Gardasil vaccine (yeast). On an unspecified date, the patient developed"joint pain. Within 24 hours, the patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 12/8/2009

269255 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
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. - / 1 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthralgia

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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0612USA00393

Write-up:Information has been received from a nurse in a physician''''s physician''s office concerning a 15 year old female who in approximately September 2006, was vaccinated with the second 0.5 mL dose of Gardasil vaccine (yeast). On an unspecified date, the patient developed"joint developed joint pain. Within 24 hours, the patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 6/14/2014

269255 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
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. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia

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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00393

Write-up:Information has been received from a nurse in a physician''s office concerning a 15 year old female who in approximately September 2006, was vaccinated with the second 0.5 mL dose of Gardasil vaccine (yeast). On an unspecified date, the patient developed joint pain. Within 24 hours, the patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 5/14/2017

269255 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
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. - / 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia

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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00393

Write-up:Information has been received from a nurse in a physician''s office concerning a 15 year old female who in approximately September 2006, was vaccinated with the second 0.5 mL dose of Gardasil vaccine (yeast). On an unspecified date, the patient developed joint pain. Within 24 hours, the patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 9/14/2017

269255 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Missouri
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. - / 1 2 - / -

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia

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: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00393

Write-up:Information has been received from a nurse in a physician''s office concerning a 15 year old female who in approximately September 2006, was vaccinated with the second 0.5 mL dose of Gardasil vaccine (yeast). On an unspecified date, the patient developed joint pain. Within 24 hours, the patient had recovered from the event (date unknown). Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269255&WAYBACKHISTORY=ON


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