National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 271164

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271164
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-20
Onset:2006-12-19
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Unevaluable event

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: ORTHO EVRA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 15 year old female who on 20-Oct-2006 was vaccinated with the first dose of Gardasil vaccine (yeast) (lot# not provided). Concomitant therapy included Ortho Evra. On 19-Dec-2006 the patien"t was diagnosed with mononucleosis by her primary care physician. The patient sought unspecified medical attention. At the time of this report the patient''''s mononucleosis persisted. The reporter felt that the mononucleosis was not related to therapy with


Changed on 12/8/2009

271164 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-20
Onset:2006-12-19
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Unevaluable event

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: ORTHO EVRA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0701USA00156

Write-up:Information has been received from a registered nurse concerning a 15 year old female who on 20-Oct-2006 was vaccinated with the first dose of Gardasil vaccine (yeast) (lot# not provided). Concomitant therapy included Ortho Evra. On 19-Dec-2006 the patien"t patient was diagnosed with mononucleosis by her primary care physician. The patient sought unspecified medical attention. At the time of this report the patient''''s patient''s mononucleosis persisted. The reporter felt that the mononucleosis was not related to therapy with Gardasil vaccine (yeast). Additional information has been requested.


Changed on 9/14/2017

271164 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-10-20
Onset:2006-12-19
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

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: ORTHO EVRA
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00156

Write-up:Information has been received from a registered nurse concerning a 15 year old female who on 20-Oct-2006 was vaccinated with the first dose of Gardasil vaccine (yeast) (lot# not provided). Concomitant therapy included Ortho Evra. On 19-Dec-2006 the patient was diagnosed with mononucleosis by her primary care physician. The patient sought unspecified medical attention. At the time of this report the patient''s mononucleosis persisted. The reporter felt that the mononucleosis was not related to therapy with Gardasil vaccine (yeast). Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271164&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166