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This is VAERS ID 271107

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 271107
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-21
Onset:2006-10-28
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Infectious mononucleosis, Epstein-Barr virus test positive

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Infectious mononucleosis, asthma, penicillin allergy, Sulfonamide allergy
Diagnostic Lab Data: serum Epstein-Barr 10/28?/06 - positive
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the seco"nd dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been con


Changed on 12/8/2009

VAERS ID: 271107 Before After
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-21
Onset:2006-10-28
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Infectious mononucleosis, Epstein-Barr virus test positive

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: Infectious mononucleosis, asthma, penicillin allergy, Sulfonamide allergy
Diagnostic Lab Data: serum Epstein-Barr 10/28?/06 - positive
CDC 'Split Type': (blank) WAES0612USA02256

Write-up:Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the seco"nd second dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''''s patient''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been con confirmed by a blood test taken at the university the patient attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report the patient had not yet recovered. Additional information has been requested.


Changed on 5/11/2010

VAERS ID: 271107 Before After
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-21 2006-10-26
Onset:2006-10-28 2006-10-31
Submitted:2007-01-16 2007-04-06
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 UN / - UN

Administered by: Other Private      Purchased by: Other Private
Symptoms: Infectious mononucleosis, Epstein-Barr virus test positive

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Asthma, penicillin allergy, Sulfonamide allergy
Preexisting Conditions: Infectious mononucleosis, asthma, penicillin allergy, Sulfonamide allergy mononucleosis
Diagnostic Lab Data: serum Epstein-Barr 10/28?/06 virus 10/31/06 - positive
CDC 'Split Type': WAES0612USA02256

Write-up:Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the second dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been confirmed by a blood test taken at the university the patient attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report the patient had not yet recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a registered nurse concerning an 18 year old female student with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 26-OCT-2006 was vaccinated in the left arm with the second dose of GARDASIL (lot #654540/0800F). There was no concomitant medication and no illnessess at the time of vaccination. It was reported that on 31-OCT-2006 the patient tested positive for mononucleosis at the university she attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report, the outcome of the event was unknown. No further information is expected.


Changed on 6/14/2014

VAERS ID: 271107 Before After
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-26
Onset:2006-10-31
Submitted:2007-04-06
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Infectious mononucleosis, Epstein-Barr virus test positive

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Asthma, penicillin allergy, Sulfonamide allergy
Preexisting Conditions: Infectious mononucleosis
Diagnostic Lab Data: serum Epstein-Barr virus 10/31/06 - positive
CDC 'Split Type': WAES0612USA02256

Write-up:Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the second dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been confirmed by a blood test taken at the university the patient attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report the patient had not yet recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a registered nurse concerning an 18 year old female student with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 26-OCT-2006 was vaccinated in the left arm with the second dose of GARDASIL (lot #654540/0800F). There was no concomitant medication and no illnessess at the time of vaccination. It was reported that on 31-OCT-2006 the patient tested positive for mononucleosis at the university she attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report, the outcome of the event was unknown. No further information is expected.


Changed on 5/14/2017

VAERS ID: 271107 Before After
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-26
Onset:2006-10-31
Submitted:2007-04-06
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 1 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Infectious mononucleosis, Epstein-Barr virus test positive

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: Asthma, penicillin allergy, Sulfonamide allergy
Preexisting Conditions: Infectious mononucleosis
Diagnostic Lab Data: serum Epstein-Barr virus 10/31/06 - positive
CDC 'Split Type': WAES0612USA02256

Write-up:Information has been received from a registered nurse concerning an 18 year old female patient with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 21-Oct-2006 was vaccinated with the second dose of Gardasil vaccine (yeast) (lot# 654540/0800F). There was no concomitant medication. It was reported by the patient''s mother that one week following vaccination, on approximately 28-Oct-2006 the patient developed mononucleosis which had been confirmed by a blood test taken at the university the patient attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report the patient had not yet recovered. Additional information has been requested. This is in follow-up to report (s) previously submitted on 1/16/2007. Information has been received from a registered nurse concerning an 18 year old female student with asthma, penicillin allergy, sulfonamide allergy and a history of infectious mononucleosis in December 2005, who on 26-OCT-2006 was vaccinated in the left arm with the second dose of GARDASIL (lot #654540/0800F). There was no concomitant medication and no illnessess at the time of vaccination. It was reported that on 31-OCT-2006 the patient tested positive for mononucleosis at the university she attended. Unspecified medical attention was sought, however the patient received no treatment. At the time of this report, the outcome of the event was unknown. No further information is expected.


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