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This is VAERS ID 269265

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269265
VAERS Form:
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Influenza like illness

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:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medi"cal attention was sought. Additional information has been requested.


Changed on 12/8/2009

269265 Before After
VAERS Form:
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
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. 0702F / 0 - / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Influenza like illness

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) WAES0612USA01120

Write-up:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medi"cal medical attention was sought. Additional information has been requested.


Changed on 4/7/2010

269265 Before After
VAERS Form:
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness

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': WAES0612USA01120

Write-up:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medical attention was sought. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Within a day or two, the patient recovered. Follow up information indicated the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


Changed on 6/14/2014

269265 Before After
VAERS Form:
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness

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': WAES0612USA01120

Write-up:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medical attention was sought. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Within a day or two, the patient recovered. Follow up information indicated the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


Changed on 5/14/2017

269265 Before After
VAERS Form:
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness

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': WAES0612USA01120

Write-up:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medical attention was sought. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Within a day or two, the patient recovered. Follow up information indicated the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


Changed on 9/14/2017

269265 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Wyoming
Vaccinated:2006-09-08
Onset:2006-09-08
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Influenza like illness

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': WAES0612USA01120

Write-up:Initial and follow up information has been received from a Registered Nurse concerning a female who on the afternoon of 08-Sep-2006 was vaccinated IM with her first dose of HPV vaccine (yeast), lot #653650/0702F, and experienced flu-like symptoms. No medical attention was sought. Additional information has been requested. This is in follow-up to report (s) previously submitted on 12/14/2006. Within a day or two, the patient recovered. Follow up information indicated the patient received her second dose of GARDASIL and had no adverse experience. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269265&WAYBACKHISTORY=ON


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