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This is VAERS ID 270766

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270766
VAERS Form:
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type':

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with HPV vaccine (lot # not reported) 0.5ml injection. Concomitant therapy included M"ontelukast sodium, fexofenadine hydrochloride (ALLEGRA) and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving HPV Vaccine. Medical attention was sought. Unspecified blood test were performe


Changed on 12/8/2009

270766 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / - UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type': (blank) WAES0701USA01029

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with HPV vaccine GARDASIL (lot # not reported) 0.5ml injection. Concomitant therapy included M"ontelukast Montelukast sodium, fexofenadine hydrochloride (ALLEGRA) ALLEGRA and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving HPV Vaccine. GARDASIL. Medical attention was sought. Unspecified blood test were performe performed. At the time of reporting, the outcome was unspecified. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


Changed on 1/5/2010

270766 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0961F / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type': WAES0701USA01029

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with GARDASIL (lot # not reported) 0.5ml injection. Concomitant therapy included Montelukast sodium, ALLEGRA and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving GARDASIL. Medical attention was sought. Unspecified blood test were performed. At the time of reporting, the outcome was unspecified. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


Changed on 6/14/2014

270766 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type': WAES0701USA01029

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with GARDASIL (lot # not reported) 0.5ml injection. Concomitant therapy included Montelukast sodium, ALLEGRA and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving GARDASIL. Medical attention was sought. Unspecified blood test were performed. At the time of reporting, the outcome was unspecified. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


Changed on 5/14/2017

270766 Before After
VAERS Form:
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type': WAES0701USA01029

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with GARDASIL (lot # not reported) 0.5ml injection. Concomitant therapy included Montelukast sodium, ALLEGRA and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving GARDASIL. Medical attention was sought. Unspecified blood test were performed. At the time of reporting, the outcome was unspecified. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


Changed on 9/14/2017

270766 Before After
VAERS Form:(blank) 1
Age:27.0
Gender:Female
Location:New Jersey
Vaccinated:2007-01-08
Onset:2007-01-08
Submitted:2007-01-17
Entered:2007-01-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Grand mal convulsion, Blood test

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: Allegra, Hormonal contraceptives, Singulair.
Current Illness:
Preexisting Conditions: Sulfonamide allergy
Allergies:
Diagnostic Lab Data: Diagnostic laboratory 01/08/07 unspecified.
CDC 'Split Type': WAES0701USA01029

Write-up:Information has been received from a 27 year old female consumer with sulfa drug allergy and pertinent medical history reported as none who on 08 Jan 2007 was vaccainted with GARDASIL (lot # not reported) 0.5ml injection. Concomitant therapy included Montelukast sodium, ALLEGRA and birth control (unspecified). The consumer reported that on 08 Jan 2007, she had a grand mal seizure after receiving GARDASIL. Medical attention was sought. Unspecified blood test were performed. At the time of reporting, the outcome was unspecified. Upon internal review, seizure was considered to be an other important medical event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=270766&WAYBACKHISTORY=ON


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