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This is VAERS ID 276106

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276106
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, 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: unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a female (age not reported) with pertinent medical history and drug reactions/allergies not reported who in December 2006 (before Christmas) was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeas"t), injection 0.5 mL. Concomitant medication was not reported. Subsequently, on an unspecified date, the patient experienced redness, swelling and itching at injection site. The patient sought unspecified medial attention. The outcome of the event was not


Changed on 12/8/2009

276106 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site pruritus, 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: unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0701USA00301

Write-up:Information has been received from a physician concerning a female (age not reported) with pertinent medical history and drug reactions/allergies not reported who in December 2006 (before Christmas) was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeas"t), (yeast), injection 0.5 mL. Concomitant medication was not reported. Subsequently, on an unspecified date, the patient experienced redness, swelling and itching at injection site. The patient sought unspecified medial attention. The outcome of the event was not reported. Additional information has been requested.


Changed on 3/2/2010

276106 Before After
VAERS Form:
Age:(blank) 22.0
Gender:Female
Location:Unknown Connecticut
Vaccinated:0000-00-00 2006-12-18
Onset:0000-00-00 2006-12-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - 0 - RA / - IJ

Administered by: Other Private      Purchased by: Other Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
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: unknown
Current Illness: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00301

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a physician concerning a 22 year old female (age not reported) working in public relations (weight 146#, height 64.5") with pertinent medical history and drug reactions/allergies not reported penicillin allergy who in December 2006 on 18-DEC-2006 (before Christmas) was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast), injection (yeast) (lot #654540/1151F), injection, 0.5 mL. mL, in the right deltoid. Concomitant medication was not reported. Subsequently, on an unspecified date, 26-DEC-2006, the patient experienced called the physician''s office and complained of redness, swelling swelling, soreness and itching at injection site. site from the last week. The physician instructed the patient to ice the site locally and take BENADRYL OTC and CHLOR-TRIMETON for the itch. The patient sought unspecified medial medical attention. The outcome of On 28-DEC-2006, the event was not reported. patient recovered from the events. Additional information has been requested. is not expected.


Changed on 6/14/2014

276106 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Connecticut
Vaccinated:2006-12-18
Onset:2006-12-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 RA / IJ

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: unknown
Current Illness: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00301

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a physician concerning a 22 year old female working in public relations (weight 146#, height 64.5") with pertinent medical history and penicillin allergy who on 18-DEC-2006 (before Christmas) was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot #654540/1151F), injection, 0.5 mL, in the right deltoid. Concomitant medication was not reported. Subsequently, on 26-DEC-2006, the patient called the physician''s office and complained of redness, swelling, soreness and itching at injection site from the last week. The physician instructed the patient to ice the site locally and take BENADRYL OTC and CHLOR-TRIMETON for the itch. The patient sought unspecified medical attention. On 28-DEC-2006, the patient recovered from the events. Additional information is not expected.


Changed on 5/14/2017

276106 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Connecticut
Vaccinated:2006-12-18
Onset:2006-12-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 RA / IJ

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: unknown
Current Illness: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00301

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a physician concerning a 22 year old female working in public relations (weight 146#, height 64.5") with pertinent medical history and penicillin allergy who on 18-DEC-2006 (before Christmas) was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot #654540/1151F), injection, 0.5 mL, in the right deltoid. Concomitant medication was not reported. Subsequently, on 26-DEC-2006, the patient called the physician''s office and complained of redness, swelling, soreness and itching at injection site from the last week. The physician instructed the patient to ice the site locally and take BENADRYL OTC and CHLOR-TRIMETON for the itch. The patient sought unspecified medical attention. On 28-DEC-2006, the patient recovered from the events. Additional information is not expected.


Changed on 9/14/2017

276106 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:Connecticut
Vaccinated:2006-12-18
Onset:2006-12-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 RA / IJ

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: unknown
Current Illness: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00301

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Information has been received from a physician concerning a 22 year old female working in public relations (weight 146#, height 64.5") with pertinent medical history and penicillin allergy who on 18-DEC-2006 (before Christmas) was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot #654540/1151F), injection, 0.5 mL, in the right deltoid. Concomitant medication was not reported. Subsequently, on 26-DEC-2006, the patient called the physician''s office and complained of redness, swelling, soreness and itching at injection site from the last week. The physician instructed the patient to ice the site locally and take BENADRYL OTC and CHLOR-TRIMETON for the itch. The patient sought unspecified medical attention. On 28-DEC-2006, the patient recovered from the events. Additional information is not expected.


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