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This is VAERS ID 276110

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276110
VAERS Form:
Age:14.0
Gender:Female
Location:Tennessee
Vaccinated:2006-12-28
Onset:2006-12-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654389/0961F / 1 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Inappropriate schedule of drug administration, No adverse effect

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

Write-up:Information has been received from a registered nurse concerning a 14 year old female with no pre-existing conditions who on 29, Nov 2006, was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 28, Dec 2006, the patient was vacci"nated with second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 654389/0961F) IM right arm 30 days after the 1st dose. At the time of the vaccination, the patient had no illness. The patient did not experience adverse effects. No additional infor


Changed on 12/8/2009

276110 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Tennessee
Vaccinated:2006-12-28
Onset:2006-12-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654389/0961F / 1 RA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Inappropriate schedule of drug administration, No adverse effect

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0702USA00159

Write-up:Information has been received from a registered nurse concerning a 14 year old female with no pre-existing conditions who on 29, Nov 2006, was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 28, Dec 2006, the patient was vacci"nated vaccinated with second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 654389/0961F) IM right arm 30 days after the 1st dose. At the time of the vaccination, the patient had no illness. The patient did not experience adverse effects. No additional infor information is expected.


Changed on 9/14/2017

276110 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Tennessee
Vaccinated:2006-12-28
Onset:2006-12-28
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654389/0961F / 1 2 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Inappropriate schedule of drug administration, No adverse effect

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA00159

Write-up:Information has been received from a registered nurse concerning a 14 year old female with no pre-existing conditions who on 29, Nov 2006, was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). On 28, Dec 2006, the patient was vaccinated with second dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # 654389/0961F) IM right arm 30 days after the 1st dose. At the time of the vaccination, the patient had no illness. The patient did not experience adverse effects. No additional information is expected.


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