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This is VAERS ID 276679

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276679
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On"approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-


Changed on 12/8/2009

276679 Before After
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On"approximately On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR- 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


Changed on 3/2/2010

276679 Before After
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


Changed on 4/7/2010

276679 Before After
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


Changed on 6/14/2014

276679 Before After
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


Changed on 5/14/2017

276679 Before After
VAERS Form:
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - - / IM

Administered by: Private      Purchased by: Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


Changed on 9/14/2017

276679 Before After
VAERS Form:(blank) 1
Age:30.0
Gender:Female
Location:Florida
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / - UNK - / IM

Administered by: Private      Purchased by: Other
Symptoms: Acne, Anxiety, Condition aggravated, Inappropriate schedule of drug administration

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: hormonal contraceptives
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02859

Write-up:Information has been received from a registered nurse concerning a 30 year old female with acne who on 25-SEP-2006 was first vaccinated IM with 0.5 ml of Gardasil (lot# 654741/0013U). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 25-SEP-2006 the patient experienced increased acne. On 25-NOV-2006, the patient received her second dose of Gardasil. Her acne became progressively worse. On 12-MAR-2007, the patient was vaccinated with the third dose of Gardasil. On 12-MAR-2007, she experienced severe anxiety. It was noted that the patient''s acne was related to Gardasil. No treatment or lab testing was provided. Subsequently, the patient had not recovered from increased acne. The patient''s severe anxiety resolved in 24 hours. Additional information has been requested. The registered nurse reported that 3 other patients'' experiences after Gardasil administration (WAES 0703USA02840, WAES 0703USA02797, WAES0703USA02815).


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