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This is VAERS ID 269778

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269778
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2006-12-11
Onset:2006-12-20
Submitted:2006-12-20
Entered:2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Pregnancy test false positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: urine pregnancy test in office (12-20-06) positive
CDC 'Split Type':

Write-up:Patient pregnancy unbeknownst to provider when vaccine administered. Patient didn''''t divulge pregnancy test at home. Was positive one month prior.


Changed on 12/8/2009

269778 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2006-12-11
Onset:2006-12-20
Submitted:2006-12-20
Entered:2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pregnancy test false positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: urine pregnancy test in office (12-20-06) positive
CDC 'Split Type':

Write-up:Patient pregnancy unbeknownst to provider when vaccine administered. Patient didn''''t didn''t divulge pregnancy test at home. Was positive one month prior.


Changed on 9/14/2017

269778 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:California
Vaccinated:2006-12-11
Onset:2006-12-20
Submitted:2006-12-20
Entered:2006-12-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Pregnancy test false positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: urine pregnancy test in office (12-20-06) positive
CDC 'Split Type':

Write-up:Patient pregnancy unbeknownst to provider when vaccine administered. Patient didn''t divulge pregnancy test at home. Was positive one month prior.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269778&WAYBACKHISTORY=ON


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