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This is VAERS ID 271120

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271120
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant t"herapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smea


Changed on 12/8/2009

271120 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': (blank) WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant t"herapy therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smea smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


Changed on 8/31/2010

271120 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


Changed on 4/13/2011

271120 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


Changed on 5/13/2011

271120 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


Changed on 6/11/2011

271120 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


Changed on 9/14/2017

271120 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Tennessee
Vaccinated:2006-10-21
Onset:2006-10-21
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 1 - / IM

Administered by: Other      Purchased by: Other
Symptoms: Injection site erythema, Injection site oedema, Smear cervix, Smear cervix abnormal, Smear cervix normal, Vaginitis bacterial

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: hormonal contraceptives
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: cervical smear, 12/8/06, + High risk HPV types; cervical smear 11/04, negative; cervical smear 12/09/05, negative.
CDC 'Split Type': WAES0612USA02744

Write-up:Information has been received from a nurse practitioner concerning a 19 year old female with an allergy to penicillin who on 21 Oct 2006 was vaccinated intramuscularly in the left deltoid with the first dose of Gardasil (Lot #653650/0702F). Concomitant therapy included hormonal contraceptives (unspecified). On 21 Oct 2006 the patient experienced minor redness and swelling at the injection site, which later resolved. On 08 Dec 2006 the patient presented with bacterial vaginosis and had a positive pap smear test for high risk HPV types. It was noted that on an unspecified date in November 2006 and on 09 Dec 2005 the patient''s pap smear tests were negative. Subsequently, unspecified medical attention was sought and the patient had not recovered from positive pap smear test. Additional information has been requested.


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