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This is VAERS ID 276109

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276109
VAERS Form:
Age:38.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Ocular hyperaemia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Colitis ulcerative
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 38 year old female with colitis ulcerative and no allergies who on 22, Jan 2007 was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 22, Jan 2007 the patient ha"d eye redness of the white of the eye, tiredness, fatigue and lightheadedness. As of 05, Feb 2007, the patient''''s symptoms continued. Additional information has been requested.


Changed on 12/8/2009

276109 Before After
VAERS Form:
Age:38.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Fatigue, Ocular hyperaemia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Colitis ulcerative
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0701USA04534

Write-up:Information has been received from a nurse practitioner concerning a 38 year old female with colitis ulcerative and no allergies who on 22, Jan 2007 was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 22, Jan 2007 the patient ha"d had eye redness of the white of the eye, tiredness, fatigue and lightheadedness. As of 05, Feb 2007, the patient''''s patient''s symptoms continued. Additional information has been requested.


Changed on 9/14/2017

276109 Before After
VAERS Form:(blank) 1
Age:38.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / -

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Fatigue, Ocular hyperaemia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Colitis ulcerative
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0701USA04534

Write-up:Information has been received from a nurse practitioner concerning a 38 year old female with colitis ulcerative and no allergies who on 22, Jan 2007 was vaccinated with a first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 22, Jan 2007 the patient had eye redness of the white of the eye, tiredness, fatigue and lightheadedness. As of 05, Feb 2007, the patient''s symptoms continued. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276109&WAYBACKHISTORY=ON


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