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This is VAERS ID 272342

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272342
VAERS Form:
Age:22.0
Gender:Female
Location:Washington
Vaccinated:2006-11-11
Onset:2006-11-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Tenderness, Contusion, Injection site swelling

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

Write-up:Information has been received from an R.N. concerning a 22 year old female patient with an allergy to codeine who on 11-NOV-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast); and according to the nurse, developed severe swe"lling on the injection site arm after the first dose. The patient received the first vaccination at another office and no information was available on where the first vaccination was administered or the physician involved in the first vaccination. On 16-


Changed on 12/8/2009

272342 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Washington
Vaccinated:2006-11-11
Onset:2006-11-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Tenderness, Contusion, Injection site swelling

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: UNK
Current Illness:
Preexisting Conditions: hypersensitivity
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA02181

Write-up:Information has been received from an R.N. concerning a 22 year old female patient with an allergy to codeine who on 11-NOV-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast); and according to the nurse, developed severe swe"lling swelling on the injection site arm after the first dose. The patient received the first vaccination at another office and no information was available on where the first vaccination was administered or the physician involved in the first vaccination. On 16- 16-JAN-2007 the patient was seen in the office. She was breast feeding, and was reported to have been breast feeding when the first vaccination was administered. The patient reported that she had developed an egg shaped swelling at the injection site on the left upper arm that lasted for more than one week after the first vaccination. No timeline on the development of the swelling in relation to the vaccination was available. The arm was still bruised and tender 2 months after the first vaccination. The second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) has not been administered. At the time of the report, the patient was recovering. Additional information has been requested.


Changed on 9/14/2017

272342 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:Washington
Vaccinated:2006-11-11
Onset:2006-11-11
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Tenderness, Contusion, Injection site swelling

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: UNK
Current Illness:
Preexisting Conditions: hypersensitivity
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA02181

Write-up:Information has been received from an R.N. concerning a 22 year old female patient with an allergy to codeine who on 11-NOV-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast); and according to the nurse, developed severe swelling on the injection site arm after the first dose. The patient received the first vaccination at another office and no information was available on where the first vaccination was administered or the physician involved in the first vaccination. On 16-JAN-2007 the patient was seen in the office. She was breast feeding, and was reported to have been breast feeding when the first vaccination was administered. The patient reported that she had developed an egg shaped swelling at the injection site on the left upper arm that lasted for more than one week after the first vaccination. No timeline on the development of the swelling in relation to the vaccination was available. The arm was still bruised and tender 2 months after the first vaccination. The second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) has not been administered. At the time of the report, the patient was recovering. Additional information has been requested.


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