National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 271366

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271366
VAERS Form:
Age:
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Condition aggravated, Crohn''s disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the pa"tient had a flair up of Crohn''''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was invo


Changed on 12/8/2009

271366 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Condition aggravated, Crohn's disease, Crohn''s disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA03418

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''''s Crohn''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the pa"tient patient had a flair up of Crohn''''s Crohn''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was invo involved. At the time of this report, the patient was recovering. The flair up of Crohn''s disease was considered to be disabling. Additional information has been requested.


Changed on 1/5/2010

271366 Before After
VAERS Form:
Age:(blank) 15.0
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Crohn's disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA03418

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the patient had a flair up of Crohn''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was involved. At the time of this report, the patient was recovering. The flair up of Crohn''s disease was considered to be disabling. Additional information has been requested.


Changed on 6/14/2014

271366 Before After
VAERS Form:
Age:15.0
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Crohn's disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA03418

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the patient had a flair up of Crohn''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was involved. At the time of this report, the patient was recovering. The flair up of Crohn''s disease was considered to be disabling. Additional information has been requested.


Changed on 5/14/2017

271366 Before After
VAERS Form:
Age:15.0
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Crohn's disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA03418

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the patient had a flair up of Crohn''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was involved. At the time of this report, the patient was recovering. The flair up of Crohn''s disease was considered to be disabling. Additional information has been requested.


Changed on 9/14/2017

271366 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Unknown
Location:Connecticut
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2007-01-26
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Condition aggravated, Crohn's disease

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: UNK
Current Illness:
Preexisting Conditions: Crohn''s disease
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA03418

Write-up:Information has been received from a physician concerning a patient (age and gender unknown) with Crohn''s disease who on 10-NOV-2006 was vaccinated intramuscularly with a 0.5 mL dose of Gardasil vaccine (yeast) (Lot # 653978/0955F). On 11-NOV-2006 the patient had a flair up of Crohn''s disease after receiving the Gardasil vaccine (yeast). The flair up was so severe that the patient had to be out of school for a month. The patient sought unspecified medical attention. No product quality complaint was involved. At the time of this report, the patient was recovering. The flair up of Crohn''s disease was considered to be disabling. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271366&WAYBACKHISTORY=ON


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