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This is VAERS ID 276157

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276157
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Erythema, Eye swelling, Pruritus

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:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no pertinent medical history and no previous reactions who on 26, Feb 2007, was vaccinated with HPV rL1 06 11 16 18 VLP vaccine (yeast) first dose. Concomitant ther"apy included hepatitis A vaccine (inactive) (manufacturer unknown), diphtheria toxoid and tetanus toxoid all administered on the same day (26, Feb 2007). The nurse did not know if the vaccines were administered in the same arm as HPV rL1 6 11 16 18 VLP va


Changed on 12/8/2009

276157 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Erythema, Eye swelling, Pruritus

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:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA00984

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no pertinent medical history and no previous reactions who on 26, Feb 2007, was vaccinated with HPV rL1 06 11 16 18 VLP vaccine (yeast) first dose. Concomitant ther"apy therapy included hepatitis A vaccine (inactive) (manufacturer unknown), diphtheria toxoid and tetanus toxoid all administered on the same day (26, Feb 2007). The nurse did not know if the vaccines were administered in the same arm as HPV rL1 6 11 16 18 VLP va vaccine. ON 26, Feb 2007, the patient developed swelling around both eyes and her face became red and itchy. The patient did not have a fever or any other symptoms. Unspecified medical attention was sought. On 03, Mar 2007, the patient recovered from swelling around both eyes and red and itchy face. Additional information has been requested.


Changed on 3/2/2010

276157 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown Virginia
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTOX: DIPHTHERIA TOXOIDS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 1208F / 0 UN / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN

Administered by: Unknown Public      Purchased by: Unknown Public
Symptoms: Erythema, Eye swelling, Pruritus

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 Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00984

Write-up:This is in follow-up to report (s) previously submitted on 4/6/2007. Information has been received from a registered nurse concerning a 16 year old female with no pertinent medical history and no previous reactions who on 26, Feb 2007, at 3:15 p.m. was vaccinated with HPV rL1 06 11 16 18 VLP vaccine (yeast) first dose. Concomitant therapy included hepatitis A vaccine (inactive) (manufacturer unknown), diphtheria toxoid and tetanus toxoid all administered on the same day (26, Feb 2007). The nurse did not know if the vaccines were administered in the same arm as HPV rL1 6 11 16 18 VLP vaccine. ON On 26, Feb 2007, the patient developed swelling around both eyes and her face became red and itchy. The patient did not have a fever or any other symptoms. Unspecified medical attention was sought. On 03, 04 Mar 2007, one week later, the patient recovered from swelling around both eyes and red and itchy face. Additional information has been requested. In follow-up it was reported that the patient came into the clinic, one week after the GARDASIL was given. She complained of swelling around both eyes, face itching and red. The patient denied any trouble breathing or trouble swallowing. The swelling and itching starte the day the vaccine was given, on 26-FEB-2007. When the client came into the clinic there was no swelling and no redness on exam. The patient was advised by the physician not to get the second dose of GARDASIL. It was reported that the patient recovered 1 week later. In follow-up the nurse reported that after the patient received her first dose of GARDASIL she developed swelling around both of her eyes and her face became red and itchy. The patient did not have a fever or any other symptoms. That same day, she was vaccinated with VAQTA (inactive) (manufacturer unknown), diphteria toxiod and tetanus toxoid. The nurse did not know if the vaccines were administered in the same arm. No further information is available. Additional information is not expected.


Changed on 9/14/2017

276157 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Virginia
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTOX: DIPHTHERIA TOXOIDS (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 1 UN / IM
TTOX: TETANUS TOXOID (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN

Administered by: Public      Purchased by: Public
Symptoms: Erythema, Eye swelling, Pruritus

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:
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA00984

Write-up:This is in follow-up to report (s) previously submitted on 4/6/2007. Information has been received from a registered nurse concerning a 16 year old female with no pertinent medical history and no previous reactions who on 26, Feb 2007, at 3:15 p.m. was vaccinated with HPV rL1 06 11 16 18 VLP vaccine (yeast) first dose. Concomitant therapy included hepatitis A vaccine (inactive) (manufacturer unknown), diphtheria toxoid and tetanus toxoid all administered on the same day (26, Feb 2007). The nurse did not know if the vaccines were administered in the same arm as HPV rL1 6 11 16 18 VLP vaccine. On 26, Feb 2007, the patient developed swelling around both eyes and her face became red and itchy. The patient did not have a fever or any other symptoms. Unspecified medical attention was sought. On 04 Mar 2007, one week later, the patient recovered from swelling around both eyes and red and itchy face. Additional information has been requested. In follow-up it was reported that the patient came into the clinic, one week after the GARDASIL was given. She complained of swelling around both eyes, face itching and red. The patient denied any trouble breathing or trouble swallowing. The swelling and itching starte the day the vaccine was given, on 26-FEB-2007. When the client came into the clinic there was no swelling and no redness on exam. The patient was advised by the physician not to get the second dose of GARDASIL. It was reported that the patient recovered 1 week later. In follow-up the nurse reported that after the patient received her first dose of GARDASIL she developed swelling around both of her eyes and her face became red and itchy. The patient did not have a fever or any other symptoms. That same day, she was vaccinated with VAQTA (inactive) (manufacturer unknown), diphteria toxiod and tetanus toxoid. The nurse did not know if the vaccines were administered in the same arm. No further information is available. Additional information is not expected.


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