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This is VAERS ID 276133

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276133
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-16
Onset:2006-12-18
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654885/1424F / - UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: AMITRIPTYLIN, KEFLEX, FLORINEF, ROZEREM
Current Illness:
Preexisting Conditions: Fibromyalgia; Ehlers-Danlos syndrome; migraine; Insomnia
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female with fibromyalgia, Ehlers-Danlos syndrome, migraine and insomnia and no know drug allergies who on 16, Dec 2006 was vaccinated intramuscularly with a 0.5 mL dose of HPV rL1 6 1"1 16 18 VLP vaccine (yeast) (lot # 654885/1424F). Concomitant therapy included amitriptyline hydrochloride (AMITRIPTYLIN), ramelteon (ROZEREM), cephalexin (KEFLEX) and fludrocrtisone acetate (FLORINEF). On 18, Dec 2006 (also reported as /"several hours af


Changed on 12/8/2009

VAERS ID: 276133 Before After
Age:16.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-16
Onset:2006-12-18
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654885/1424F / - UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: AMITRIPTYLIN, KEFLEX, FLORINEF, ROZEREM
Current Illness:
Preexisting Conditions: Fibromyalgia; Ehlers-Danlos syndrome; migraine; Insomnia
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA00597

Write-up:Information has been received from a physician concerning a 16 year old female with fibromyalgia, Ehlers-Danlos syndrome, migraine and insomnia and no know drug allergies who on 16, Dec 2006 was vaccinated intramuscularly with a 0.5 mL dose of HPV rL1 6 1"1 11 16 18 VLP vaccine (yeast) (lot # 654885/1424F). Concomitant therapy included amitriptyline hydrochloride (AMITRIPTYLIN), ramelteon (ROZEREM), cephalexin (KEFLEX) and fludrocrtisone acetate (FLORINEF). On 18, Dec 2006 (also reported as /"several "several hours af after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast)") the patient developed mild hives on her neck. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. On 19, Dec 2006 ("by the next morning") the hives resolved without treatment. No further problems were reported. No product quality complaint was involved. Additional information has been requested.


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