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This is VAERS ID 274750

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274750
VAERS Form:
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type':

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right /"glute/" with a first dose"of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph


Changed on 12/8/2009

274750 Before After
VAERS Form:
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills, Hyperhidrosis, Inappropriate schedule of drug administration, Influenza, Lymphadenopathy, Myalgia, Musculoskeletal stiffness

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type': (blank) WAES0701USA03988

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right /"glute/" "glute" with a first dose"of dose of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph nodes. Subsequently, the patient recovered. It was reported that the patient thought that she had the flu. On 12-JAN-2007 the patient was vaccinated, into the right "glute" with a second dose of HPV (lot # 654389/0961F). On 17-JAN-2007 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 19-JAN-2007 the patient experienced enlarged cervical lymph nodes. The nurse practitioner felt that the patient had an "exaggerated immune response." At the time of the report, the patient''s stiff neck and myalgia and mild chills and sweats and temperature of 101 and enlarged cervical lymph nodes persisted. The patient refused her third vaccination. No further information is available.


Changed on 9/14/2011

274750 Before After
VAERS Form:
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills, Drug administered at inappropriate site, Hyperhidrosis, Inappropriate schedule of drug administration, Influenza, Lymphadenopathy, Myalgia, Musculoskeletal stiffness

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type': WAES0701USA03988

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right "glute" with a first dose of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph nodes. Subsequently, the patient recovered. It was reported that the patient thought that she had the flu. On 12-JAN-2007 the patient was vaccinated, into the right "glute" with a second dose of HPV (lot # 654389/0961F). On 17-JAN-2007 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 19-JAN-2007 the patient experienced enlarged cervical lymph nodes. The nurse practitioner felt that the patient had an "exaggerated immune response." At the time of the report, the patient''s stiff neck and myalgia and mild chills and sweats and temperature of 101 and enlarged cervical lymph nodes persisted. The patient refused her third vaccination. No further information is available.


Changed on 6/14/2014

274750 Before After
VAERS Form:
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills, Drug administered at inappropriate site, Hyperhidrosis, Influenza, Lymphadenopathy, Myalgia, Musculoskeletal stiffness

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type': WAES0701USA03988

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right "glute" with a first dose of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph nodes. Subsequently, the patient recovered. It was reported that the patient thought that she had the flu. On 12-JAN-2007 the patient was vaccinated, into the right "glute" with a second dose of HPV (lot # 654389/0961F). On 17-JAN-2007 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 19-JAN-2007 the patient experienced enlarged cervical lymph nodes. The nurse practitioner felt that the patient had an "exaggerated immune response." At the time of the report, the patient''s stiff neck and myalgia and mild chills and sweats and temperature of 101 and enlarged cervical lymph nodes persisted. The patient refused her third vaccination. No further information is available.


Changed on 5/14/2017

274750 Before After
VAERS Form:
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / -

Administered by: Other      Purchased by: Other
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills, Drug administered at inappropriate site, Hyperhidrosis, Influenza, Lymphadenopathy, Myalgia, Musculoskeletal stiffness

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type': WAES0701USA03988

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right "glute" with a first dose of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph nodes. Subsequently, the patient recovered. It was reported that the patient thought that she had the flu. On 12-JAN-2007 the patient was vaccinated, into the right "glute" with a second dose of HPV (lot # 654389/0961F). On 17-JAN-2007 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 19-JAN-2007 the patient experienced enlarged cervical lymph nodes. The nurse practitioner felt that the patient had an "exaggerated immune response." At the time of the report, the patient''s stiff neck and myalgia and mild chills and sweats and temperature of 101 and enlarged cervical lymph nodes persisted. The patient refused her third vaccination. No further information is available.


Changed on 9/14/2017

274750 Before After
VAERS Form:(blank) 1
Age:60.0
Gender:Female
Location:Washington
Vaccinated:2006-10-30
Onset:2006-10-30
Submitted:2007-03-15
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 - / -

Administered by: Other      Purchased by: Other
Symptoms: Blood alkaline phosphatase, Blood creatinine, Body temperature increased, Chills, Drug administered at inappropriate site, Hyperhidrosis, Influenza, Lymphadenopathy, Myalgia, Musculoskeletal stiffness

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: Synthroid
Current Illness:
Preexisting Conditions: Hypothyroidism; Cigarette smoker
Allergies:
Diagnostic Lab Data: body temp 11/04/06 101; body temp, 01/17/07 101; serum C-reactive 01/22/07 14.5; serum alkaline 01/22/07 106
CDC 'Split Type': WAES0701USA03988

Write-up:Initial and follow-up information has been received from a nurse practitioner concerning a 60 year old white female cigarette smoker (40 cigarettes per day) with hypothyroidism who on 30-OCT-2006 was vaccinated, into the right "glute" with a first dose of HPV (lot # 653978/0955F). Concomitant therapy included levothyroxine Na (SYNTHROID). On 04-NOV-2006 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 06-NOV-2006 the patient experienced enlarged cervical lymph nodes. Subsequently, the patient recovered. It was reported that the patient thought that she had the flu. On 12-JAN-2007 the patient was vaccinated, into the right "glute" with a second dose of HPV (lot # 654389/0961F). On 17-JAN-2007 the patient experienced stiff neck, myalgia, mild chills, sweats and temperature of 101. On 19-JAN-2007 the patient experienced enlarged cervical lymph nodes. The nurse practitioner felt that the patient had an "exaggerated immune response." At the time of the report, the patient''s stiff neck and myalgia and mild chills and sweats and temperature of 101 and enlarged cervical lymph nodes persisted. The patient refused her third vaccination. No further information is available.


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