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This is VAERS ID 270243

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270243
VAERS Form:
Age:
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomita"ntly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''''s outcome was unknown. No product quality


Changed on 12/8/2009

270243 Before After
VAERS Form:
Age:
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0612USA00383

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomita"ntly. concomitantly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''''s patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 1/5/2010

270243 Before After
VAERS Form:
Age:(blank) 19.0
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00383

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomitantly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 6/14/2014

270243 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00383

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomitantly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 5/14/2017

270243 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00383

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomitantly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 9/14/2017

270243 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Indiana
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Pallor, Urticaria

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: DEPO-PROVERA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0612USA00383

Write-up:Information has been received from a health professional concerning a female patient who on 01-Dec-2006 was vaccinated IM with a 0.5 ml dose of HPV vaccine (yeast). It was noted that medroxyprogesterone acetate (DEPO-PROVERA) may have been given concomitantly. On 01-Dec-2006 the patient developed hives and turned pale white. She was admitted to the emergency room and there was no further information if she will be admitted. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=270243&WAYBACKHISTORY=ON


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