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This is VAERS ID 270265

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270265
VAERS Form:
Age:9.0
Gender:Female
Location:Georgia
Vaccinated:2006-11-03
Onset:0000-00-00
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of HPV Vaccine ("lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been


Changed on 12/8/2009

270265 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Georgia
Vaccinated:2006-11-03
Onset:0000-00-00
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of HPV Vaccine ("lot Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 2/5/2010

270265 Before After
VAERS Form:
Age:9.0 17.0
Gender:Female
Location:Georgia
Vaccinated:2006-11-03
Onset:0000-00-00
Submitted:2007-01-05
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested.


Changed on 5/11/2010

270265 Before After
VAERS Form:
Age:17.0 9.0
Gender:Female
Location:Georgia
Vaccinated:2006-11-03 2006-10-10
Onset:0000-00-00 2006-10-20
Submitted:2007-01-05 2007-04-06
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 0 UN / - IM

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/5/2007. Initial and follow-up information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reaction/allergies, who on 10-OCT-2006 was vaccinated intramuscularly with the first dose of GARDASIL (0.5 ml) (lot # 653735/0688F). There was no concomitant medication. Subsequently, approximately ten days after vaccination on approximately 20-OCT-2006, the patient''s mother noticed a balding spot behind the patient''s ear. The patient used a steroid cream on the area and had an appointment with a dermatologist. It was reported that the patient has some hair re-growth but not in the whole area. The patient''s mother was unsure about the completion of the recommended vaccine schedule. No further information is expected.


Changed on 6/14/2014

270265 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Georgia
Vaccinated:2006-10-10
Onset:2006-10-20
Submitted:2007-04-06
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/5/2007. Initial and follow-up information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reaction/allergies, who on 10-OCT-2006 was vaccinated intramuscularly with the first dose of GARDASIL (0.5 ml) (lot # 653735/0688F). There was no concomitant medication. Subsequently, approximately ten days after vaccination on approximately 20-OCT-2006, the patient''s mother noticed a balding spot behind the patient''s ear. The patient used a steroid cream on the area and had an appointment with a dermatologist. It was reported that the patient has some hair re-growth but not in the whole area. The patient''s mother was unsure about the completion of the recommended vaccine schedule. No further information is expected.


Changed on 5/14/2017

270265 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Georgia
Vaccinated:2006-10-10
Onset:2006-10-20
Submitted:2007-04-06
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/5/2007. Initial and follow-up information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reaction/allergies, who on 10-OCT-2006 was vaccinated intramuscularly with the first dose of GARDASIL (0.5 ml) (lot # 653735/0688F). There was no concomitant medication. Subsequently, approximately ten days after vaccination on approximately 20-OCT-2006, the patient''s mother noticed a balding spot behind the patient''s ear. The patient used a steroid cream on the area and had an appointment with a dermatologist. It was reported that the patient has some hair re-growth but not in the whole area. The patient''s mother was unsure about the completion of the recommended vaccine schedule. No further information is expected.


Changed on 9/14/2017

270265 Before After
VAERS Form:(blank) 1
Age:9.0
Gender:Female
Location:Georgia
Vaccinated:2006-10-10
Onset:2006-10-20
Submitted:2007-04-06
Entered:2007-01-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Alopecia, Hypotrichosis

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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA01074

Write-up:Information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reactions/allergies, who on 05 Sept 2006 and 03 Nov 2006 was vaccinated with the first and second doses of Gardasil (lot 653735/0688F). There was no concomitant medication. Subsequently the patient experienced thinning of hair or alopecia. Unspecified medical attention was sought. At the time of this report the patient had not recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/5/2007. Initial and follow-up information has been received from a licensed practical nurse concerning a 9 year old female with no pertinent medical history or drug reaction/allergies, who on 10-OCT-2006 was vaccinated intramuscularly with the first dose of GARDASIL (0.5 ml) (lot # 653735/0688F). There was no concomitant medication. Subsequently, approximately ten days after vaccination on approximately 20-OCT-2006, the patient''s mother noticed a balding spot behind the patient''s ear. The patient used a steroid cream on the area and had an appointment with a dermatologist. It was reported that the patient has some hair re-growth but not in the whole area. The patient''s mother was unsure about the completion of the recommended vaccine schedule. No further information is expected.


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