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This is VAERS ID 271140

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271140
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2006-12-18
Onset:2006-12-20
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654540/1161F / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pruritus

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: Lexapro, Prevacid, Toprol XL tablets, Singulair
Current Illness:
Preexisting Conditions: Asthma; Depression; Drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a nurse concerning a 19 year old female patient with asthma, depression and allergies to valproate sodium, diazepam, gabapentin and acetaminophen (+) butalbital (+) caffeine who on 18-DEC-2006 was vaccinated with her fir"st dose of HPV rL1 6 11 16 18 VLF vaccine (yeast), 1pt #654540/1161F. Concomitant therapy included montelukast sodium (MSD), escitalopram oxalate, lansoprazole, and metoprolol succinate. On 20-DEC-2006 the patient called the office and stated that the i


Changed on 12/8/2009

271140 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New York
Vaccinated:2006-12-18
Onset:2006-12-20
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654540/1161F / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pruritus

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: Lexapro, Prevacid, Toprol XL tablets, Singulair
Current Illness:
Preexisting Conditions: Asthma; Depression; Drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0612USA03353

Write-up:Information has been received from a nurse concerning a 19 year old female patient with asthma, depression and allergies to valproate sodium, diazepam, gabapentin and acetaminophen (+) butalbital (+) caffeine who on 18-DEC-2006 was vaccinated with her fir"st first dose of HPV rL1 6 11 16 18 VLF vaccine (yeast), 1pt #654540/1161F. Concomitant therapy included montelukast sodium (MSD), escitalopram oxalate, lansoprazole, and metoprolol succinate. On 20-DEC-2006 the patient called the office and stated that the i injection site was itchy. Medical attention was sought. The physician''s office to follow up with patient, her outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

271140 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New York
Vaccinated:2006-12-18
Onset:2006-12-20
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654540/1161F / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus

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: Lexapro, Prevacid, Toprol XL tablets, Singulair
Current Illness:
Preexisting Conditions: Asthma; Depression; Drug hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0612USA03353

Write-up:Information has been received from a nurse concerning a 19 year old female patient with asthma, depression and allergies to valproate sodium, diazepam, gabapentin and acetaminophen (+) butalbital (+) caffeine who on 18-DEC-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLF vaccine (yeast), 1pt #654540/1161F. Concomitant therapy included montelukast sodium (MSD), escitalopram oxalate, lansoprazole, and metoprolol succinate. On 20-DEC-2006 the patient called the office and stated that the injection site was itchy. Medical attention was sought. The physician''s office to follow up with patient, her outcome was unknown. Additional information has been requested.


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