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This is VAERS ID 269646

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269646
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site reaction, Pain, Skin disorder, Urticaria, Similar reaction on previous exposure to drug

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006,"immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room an


Changed on 12/8/2009

269646 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site reaction, Pain, Skin disorder, Urticaria, Similar reaction on previous exposure to drug, Vaccine positive rechallenge

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006,"immediately 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


Changed on 2/5/2010

269646 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Pain, Urticaria, Vaccine positive rechallenge

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


Changed on 7/31/2010

269646 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Pain, Urticaria, Vaccine positive rechallenge

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


Changed on 6/14/2014

269646 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Pain, Urticaria, Vaccine positive rechallenge

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


Changed on 5/14/2017

269646 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Pain, Urticaria, Vaccine positive rechallenge

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


Changed on 9/14/2017

269646 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-10-03
Onset:2006-10-03
Submitted:2006-12-26
Entered:2006-12-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site reaction, Pain, Urticaria, Vaccine positive rechallenge

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: Therapy unspecified
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0612USA02735

Write-up:Information has been received from a female physician assistant (age not reported) who on 03 Oct 2006 was vaccinated intramuscularly with the first 0.5ml dose of HPV vaccine. Concomitant therapy included an unspecified therapy for asthma. On 03 Oct 2006, immediately after receiving the HPV vaccine, she developed extreme pain on her skin and broke out in hives all over her body. The physician assistant stated that it felt like a cat clawing on her skin. The physician assistant went to the emergency room and was treated with asthma medication but was not admitted. No ER date was provided. On an unspecified date, the patient was recovering from the events. On 05 Dec 2006, the patient was vaccinated with a second dose of HPV vaccine. Subsequently, the patient developed an outbreak of hives in a circle around the site of injection. At the time of this report, the outcome of the event was unknown. The physician assistant considered the events of extreme pain on her skin and broke out in hives all over her body to be other important medical events as the patient was treated with asthma medication in the ER (OMIC). Additional information has been requested.


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