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| VAERS ID: | 259545 | Vaccination Date: | 2006-07-11 | | Age: | 14.0 | Onset Date: | 2006-07-11 Days later: 0 | | Gender: | Female | Submitted: | 2006-07-11 | | State: | D.C. | Entered: | 2006-07-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? Yes, 1 days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: LABS: WBC 11.7, neutros 84, lymphs 9.7. | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: Allergic rhinitis, spring pollens/ragweed/dust/mold | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dehydration, Fall, Headache, Hyperventilation, Injection site pain, Laboratory test abnormal, Muscle spasms, Speech disorder, Syncope, Vision blurred, Vomiting | | Write-up: Immediately after injection complained of severe pain at site. Fell off table and fainted for approximately 10 - 15 seconds. Hyperventilated and cried progressing Chvostek's sign in hands and feet. Rebreathing into a bag progressing to clearing of symptoms. Complained of headache, blurry vision; Vision test was normal. Vomiting x 1 in parking lot and speech was momentarily inarticulate. Sent to ER. At ER neuro exam was normal except for word recall "coffee instead of coughing" "Sired instead of tired." Continued complaint of headache. Vomited x 2. All symptoms spontaneously cleared approximately 6 hours after incident. Overnight hospitalization for observation. Neurological evaluation before discharge was normal. Diagnosis also included dehydration. No fluids were taken from 7/10/2006 PM until IV in ER. Anion gap noted on chemistries and concentration of urine obtained after several hours of hydration. Discharge diagnosis: Dehydration, Vasovagal syncope secondary to shot vs pain at injection site. 7/17/06 Medical records received from reporter/provider which included vax record, office note of 7/11 & neuro consult of 7/15 by MD who also saw her in the hospital on 7/11-12. Neuro report indicates the CT scan of head was WNL & that dx is syncope probably precipitated by pain of vax injection along w/dehydration (no fluid intake since evening of 7/10 until IVF given in ER). As of 7/15 patient continued to have throbbing HA when bending down & also c/o strong heart beats ocassionally. PMH: dehydration requiring hospitalization at age 3 yo. Also has hx of mild anxiety. Family hx: patient's mother has Fuch's disease (genetic degenertive corneal disease which her mother also had) & patient's father has depression. There are no siblings. It was noted that she had 3 episodes of emesis following vax along w/ sustaining mild concussion when fell from exam table which was characterized by brief episode of aphasia, slurred speech & possible right facial paresis noted only by patient's mother./ss 10/27/06 Received medic |
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| VAERS ID: | 260144 | Vaccination Date: | 2006-07-25 | | Age: | 13.0 | Onset Date: | 2006-07-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-07-25 | | State: | California | Entered: | 2006-07-26 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: Viral with low grade fever | | Diagnostic Lab Data: BP 90/30 90/62 110/70 110/60, BG 114 Pulse OX 99, Strep culture neg. | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA | MERCK & CO. INC. | 0144F | | | RA | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dyskinesia, Hypertonia, Hypoaesthesia, Hypotonia, Pain, Syncope | | Write-up: Patient received Hep A in right arm. Then received HPV in left arm. C/O pains, numbness. Started walking down hall fainted and had tonic/clonic movement for 15 sec. |
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| VAERS ID: | 260907 | Vaccination Date: | 2006-07-18 | | Age: | 17.0 | Onset Date: | 2006-07-18 Days later: 0 | | Gender: | Female | Submitted: | 2006-07-19 | | State: | Texas | Entered: | 2006-08-01 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: human papilloma virus, genital warts | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Rash, Swelling | | Write-up: Swelling immediately after vaccine was administered, also rash. Ice pack was applied for 5 minutes and swelling decreases. Rash was still visible, but cream was applied. |
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| VAERS ID: | 261359 | Vaccination Date: | 2006-07-13 | | Age: | 11.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-07-14 | | State: | California | Entered: | 2006-08-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | | LA | | MEN | UNKNOWN MANUFACTURER | U1920AA | 0 | | LA | | TD | UNKNOWN MANUFACTURER | C2457AA | 5 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dizziness, Lymphadenopathy, Nausea | | Write-up: Dizzy, nauseated, developed axillary lymphadenopathy on side with Menactra inoculation. |
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| VAERS ID: | 261575 | Vaccination Date: | 2006-07-12 | | Age: | 24.0 | Onset Date: | 2006-07-12 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-10 | | State: | California | Entered: | 2006-08-15 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0607USA041063 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | | TDAP | UNKNOWN MANUFACTURER | | | | | |
| Administered by: Other Purchased by: Unknown | | Symptoms: Rash | | Write-up: Information has been received from a physician concerning a 24 year old female with no medical history and no drug allergies who "last week" on approximately 12-JUL-2006 was vaccinated with HPV vaccine rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml). Concomitant therapy that day included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. The vaccines were administered in different arms. Subsequently, "12 hours after vaccination" the patient developed a rash throughout her whole body that lasted for two days. Unspecified medical attention was sought. The patient recovered two days after injection. Additional information has been requested. |
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| VAERS ID: | 261576 | Vaccination Date: | 2006-07-19 | | Age: | 16.0 | Onset Date: | 2006-07-19 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-10 | | State: | Texas | Entered: | 2006-08-15 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0607USA04314 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain, Pain, Swelling | | Write-up: Information has been received from a physician concerning an approximately 16 year old female who on 19-JUL-2006 was vaccinated with HPV rLI 6 11 16 18 VLP vaccine (yeast). It was reported that "immediately after the injection", on 19-JUL-2006, the patient experienced pain and stinging at the injection site that lasted about 2 minutes and radiated the arm. The patient also reported feeling faint following the injection and experienced swelling. It was reported that the swelling went down but the pain persisted. Unspecified medical attention was sought. Additional information has been requested. |
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| VAERS ID: | 261577 | Vaccination Date: | 2006-07-27 | | Age: | 16.0 | Onset Date: | 2006-07-27 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-10 | | State: | Florida | Entered: | 2006-08-15 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0607USA05727 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site pain, Loss of consciousness, Syncope, Syncope vasovagal | | Write-up: Information has been received from a registered nurse and a physician concerning a 16 year old female no medical history and no drug allergies who on 27-JUL-2006 was vaccinated intramuscularly in the right deltoid with the first dose of HPV rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). There were no concomitant medications. At the time of vaccination the patient experienced extreme pain at the injection site and fainted. The nurse reported that "the onset of the pain was immediate and lasted for 1 and a half to 2 minutes and then the patient passed out for 15 to 20 seconds and then was all right". The physician reported that the patient had a vasovagal syncopal episode, was not incontinent, and experienced no post- ictal state. Unspecified medical attention was sought. Subsequently, the same day the patient recovered from the extreme pain at the injection site and vasovagal syncopal episode. The patient did not wish to continue the series as a result of the adverse experience. Additional information has been requested. 01/05/2007 This is in follow-up to report(s) previously submitted on 8/10/2006. Information has been received from a registered nurse and a physician concerning a 16 year old female no medical history and no drug allergies who on 27-JUL-2006 at 13:30 was vaccinated intramuscularly in the right deltoid with the first dose of GARDASIL (0.5 ml) (lot # 653650/0702F). There were no concomitant medications. At the time of vaccination the patient experienced extreme pain at the injection site and fainted. The nurse reported that "the onset of the pain was immediate and lasted for 1 1/2 to 2 minutes and then the patient passed out for 15 to 20 seconds and then was all right". The physician reported that the patient had a vasovagal syncopal episode, was not incontinent, and experienced no post-ictal state. Unspecified medical attention was sought. Subsequently, that same day the patient recovered from the extreme pain at the injection site and vasovagal syncopal episode. The patie |
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| VAERS ID: | 261578 | Vaccination Date: | 2006-07-27 | | Age: | 21.0 | Onset Date: | 2006-07-27 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-10 | | State: | Florida | Entered: | 2006-08-15 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: hormonal contraceptives | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0607USA05775 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a physician and registered nurse concerning a 21 year old female with no medical history of drug allergies who on 27-JUL-2006 was vaccinated intramuscularly in the left deltoid with the first dose of HPV rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). Concomitant therapy included possible hormonal contraceptives (unspecified). On 27-JUL-2006 the patient experienced extreme pain at the injection site. The onset of the pain was immediate and lasted for 5 to 6 minutes and then resolved. Unspecified medical attention was sought. It was reported that the patient does not wish to continue the series of vaccinations. Additional information has been requested. |
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| VAERS ID: | 261579 | Vaccination Date: | 2006-07-28 | | Age: | 14.0 | Onset Date: | 2006-07-28 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-10 | | State: | Texas | Entered: | 2006-08-15 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA00186 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTP | UNKNOWN MANUFACTURER | | | | UN | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a physician concerning a 14 year old female who on 28-JUL-2006 was vaccinated with HPV rLI 3 11 16 18 VLP vaccine (yeast). Concomitant vaccination on 28-JUL-2006 included diphtheria toxoid (+) pertussis vaccine (unspecified) (+) tetanus toxoid. The patient stated that following vaccination on 28-JUL-2006, she " experienced a great deal of pain at the injection site". Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested. |
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| VAERS ID: | 262070 | Vaccination Date: | 2006-08-14 | | Age: | 25.0 | Onset Date: | 2006-08-22 Days later: 8 | | Gender: | Female | Submitted: | 2006-08-24 | | State: | Texas | Entered: | 2006-08-24 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: none | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: OrthoTricyclen-Lo | | Preexisting Conditions: none | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | RA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Pruritus, Rash | | Write-up: Patient developed a fine, red rash over torso and legs with itching reported on8/22/2006. |
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| VAERS ID: | 262096 | Vaccination Date: | 2006-08-14 | | Age: | 17.0 | Onset Date: | 2006-08-14 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-21 | | State: | New York | Entered: | 2006-08-25 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637C | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Asthenia, Chills, Cyanosis, Dizziness, Pallor, Pyrexia, Visual disturbance | | Write-up: 1 hr after vaccination, pt reported to feel dizzy, weak, vision went black for a few seconds, got pale with purple lips x 1/2hr. Felt better after drinking OJ. Then got temp 101F and chills x 1 day. |
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| VAERS ID: | 262242 | Vaccination Date: | 2006-08-23 | | Age: | 14.0 | Onset Date: | 2006-08-23 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-28 | | State: | Washington | Entered: | 2006-08-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA | MERCK & CO. INC. | 0706R | 1 | IM | LA | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Fall, Fracture, Syncope vasovagal | | Write-up: Vasovagal syncope shortly after receiving hep A and Gardasil vaccine, fell, hit nose on a drawer, loss of consciousness, sent to ER in transport broke nose. |
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| VAERS ID: | 262243 | Vaccination Date: | 2006-07-25 | | Age: | 16.0 | Onset Date: | 2006-07-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-28 | | State: | Washington | Entered: | 2006-08-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: MRI next AM nl | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injury, Syncope, Tremor | | Write-up: Vaccine given after physical. Pt fainted, vasovagal, hit head on carpeted cement floor. Loss of consciousness 1 min, had tonic posturing of right hand only some shaking. |
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| VAERS ID: | 262451 | Vaccination Date: | 2006-08-17 | | Age: | 18.0 | Onset Date: | 2006-08-18 Days later: 1 | | Gender: | Female | Submitted: | 2006-08-28 | | State: | California | Entered: | 2006-09-01 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: | | CDC 'Split Type': WAES0608USA04945 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Rash, Urticaria | | Write-up: Information has been received from a physician and a medical assistant concerning an 18 yr old female with no pertinent medical history or allergies, who on 17Aug06 was vaccinated IM with HPV rL1 6 11 16 18 VLP vaccine (yeast) (0.5ml) (lot 653650/0702F). There was no concomitant therapy. Subsequently, on 18Aug06 the pt developed a rash and hives. It was reported that this was not an injection site rash. The pt presented to her physician's office on 18Aug06 with hives all over her body. She was treated with oral diphenhydramine hydrochloride (Benadryl). It was also reported that the pt went to the ER twice on 19Aug06 and 20Aug06 and was treated with intravenous methylprednisolone sodium succinate (Solu Medrol) for the hives and welts all over her body and was released (it was also reported that the pt was given IV saline). The pt was scheduled to have a follow up visit with her physician within a week. At the time of this report, the pt had not recovered. The rash and generalized urticaria were felt to be other important medical events. Additional information has been requested. |
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| VAERS ID: | 262482 | Vaccination Date: | 2006-07-25 | | Age: | 23.0 | Onset Date: | 2006-07-26 Days later: 1 | | Gender: | Female | Submitted: | 2006-08-31 | | State: | Rhode Island | Entered: | 2006-08-31 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Fatigue, Feeling hot, Injection site hypersensitivity, Injection site mass, Injection site pain | | Write-up: Hard painful lump at site of injection, red, site is hot to the touch. Pt states feeling "tired & run down" since injection. |
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| VAERS ID: | 262735 | Vaccination Date: | 2006-07-31 | | Age: | 16.0 | Onset Date: | 2006-08-13 Days later: 13 | | Gender: | Female | Submitted: | 2006-09-07 | | State: | Mississippi | Entered: | 2006-09-07 | |
| Life Threatening Illness? Yes |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? Yes, 5 days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: MRI of brain, cervical, thoracic and lumbosacral spine, drug screen, pregnancy test, sed rate, Blood count, blood chemistries, Lumbar Puncture. | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0697F | 0 | IM | GM | | MNQ | SANOFI PASTEUR | 42107AA | 0 | IM | GM | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Guillain-Barre syndrome, Hypoaesthesia, Paraesthesia, Proteinuria, Red blood cell sedimentation rate increased | | Write-up: Vaccine was given on July 31 2006. She began having numbness and tingling in her feet and hands on or around August 13th or 14th, which persisted and slightly worsened until she was seen in our office on August 21st. Her neurological examination was normal, she had an elevated sedimation rate (39), mild protienuria, otherwize normal labs. MRI of her lumbosacral spine showed a (possibly old, chronic) subarachnoid cyst. She was referred to a neurologist and was seen on August 25th and was found to have weakened severely and was admitted to PICU for suspected Guillian-Barre syndrome which was confirmed by lumbar puncture. She was treated with IVIG with rapid improvement and has gone home. She is slowly improving and has residual weakness. Medical records including neurology received/reviewed. Final diagnosis is GBS. Was treated with IVIG as indicated on VAERS form. Per records pt has residual weakness. 12/19/06-progress notes received for and DC Summary DC DX: GBS. |
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| VAERS ID: | 262742 | Vaccination Date: | 2006-08-01 | | Age: | 15.0 | Onset Date: | 2006-08-01 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-05 | | State: | Virginia | Entered: | 2006-09-08 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': WAES0608USA06904 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA | MERCK & CO. INC. | | | | UN | | HPV4 | MERCK & CO. INC. | | | IM | | | MNQ | AVENTIS PASTEUR | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Convulsion, Injection site pain | | Write-up: Information has been received from a physician concerning a 15 year old female patient who in August 2006, was vaccinated IM with a dose of HPV rL1 6 11 16 18 VLP vaccine. Prior to administration, the patient received the following concomitant therapy: hepatitis A vaccine and meningococcal ACYW conjugate vaccine. The patient had a mild seizure after receiving HPV rL1 6 11 16 18 VLP vaccine injection. She also complained of a great deal of pain at injection site. Medical attention was sought. It was reported that the patient recovered 1 day after the event. Her mother called the physician at home 1 day after the injections to state that the patient was fine. Upon internal review, mild seizure was considered to be an other important medical event (OMIC). Additional information has been requested. |
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| VAERS ID: | 262743 | Vaccination Date: | 2006-08-22 | | Age: | 17.0 | Onset Date: | 2006-08-23 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-05 | | State: | Unknown | Entered: | 2006-09-08 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: Asthma | | CDC 'Split Type': WAES0608USA05911 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Chest discomfort, Erythema, Oedema peripheral | | Write-up: Information has been received from a nurse concerning her 17 year old daughter with asthma who on 8/22/06 was vaccinated IM with HPV rL1 6 11 16 18 VLP vaccine (0.5ml). On 8/23/06 the patient developed a swollen thumb and her palms became red and hot. The patient later developed a tightness in her chest. The patient was immediately taken to a physician (an allergist who was the mother's employer) who immediately gave the patient a huge dose of cetirizine hydrochloride and acetaminophen as an intervention. The patient was not hospitalized and did not got to the emergency room. It was unknown if the affected site was the same arm that the vaccine was given in. The patient subsequently recovered from the red and hot palms, swollen thumb, and chest tightness on an unspecified date. The red and hot palms, swollen thumb and chest tightness were felt to be other important medical events. Additional information has been requested. |
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| VAERS ID: | 262785 | Vaccination Date: | 2006-08-10 | | Age: | 19.0 | Onset Date: | 2006-08-15 Days later: 5 | | Gender: | Female | Submitted: | 2006-09-08 | | State: | Texas | Entered: | 2006-09-08 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Movement disorder | | Write-up: 09/01/06 pt call with c/o decreased ROM in L arm 5 days after injection administration to current date. Tx with Naproxen x 10 days and Tylenol #3. |
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| VAERS ID: | 262809 | Vaccination Date: | 2006-08-23 | | Age: | 17.0 | Onset Date: | 2006-08-27 Days later: 4 | | Gender: | Female | Submitted: | 2006-09-06 | | State: | Georga | Entered: | 2006-09-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Computed axial 8/29/06 lump having 2 smaller and 1 larger lymph nodes involved. LABS: all WNL. CT of chest/abd/pelvis revealed 14mm circumscribed noe in left supraclavicular node & several less than 1 cm nodes in bilateral axillary areas | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: Sulfonamide allergy | | CDC 'Split Type': WAES0608USA06930 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0689F | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypokinesia, Lymphadenopathy, Skin nodule | | Write-up: Information had been received from a healthcare worker concerning a 17 year old female pt with a sulfonamide allergy who on 8/23/06 was vaccinated IM in left upper arm with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653736/089F. There was no concomitant medication. it was reported that 5 days after vaccination, on 8/27/06, the pt developed lymph node swelling in the clavicle area, described as grape size. The pt complained of interference of upper arm movement and felt something was present in the clavicle area. Unspecified blood work was done. On 8/29/06 a CAT scan was performed and lump was described as having 2 smaller and 1 larger lymph nodes involved. On 8/30/06 the pt was scheduled for surgery to have the lymph nodes removed and biopsied. As of the report date, the pt had not recovered. The reporter felt that the lymph node swelling and interference with upper arm movement were other important medical events (OMIC). Additional information has been requested. 10/13/06 Received medical records from hospital which reeal patient seen in ER 8/29/06 for enlarged lymph node left supraclavicular area which was tender to palpation. Final Dx: lymphadenopathy. 8/31/06 surgical biopsy done of left node & several other lymph nodes were palpated & sent to lab. |
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| VAERS ID: | 262847 | Vaccination Date: | 2006-09-06 | | Age: | 25.0 | Onset Date: | 2006-09-06 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-11 | | State: | Kentucky | Entered: | 2006-09-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: yearly examination | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | | MNQ | AVENTIS PASTEUR | U2117AA | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Erythema, Joint range of motion decreased, Pain, Swelling | | Write-up: Patient said right deltoid area, became red, swollen, quarter size hard knot, achy, painful to raise arm. Knot was hot to touch. |
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| VAERS ID: | 262872 | Vaccination Date: | 2006-09-02 | | Age: | 11.0 | Onset Date: | 2006-09-02 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-02 | | State: | Florida | Entered: | 2006-09-12 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: vital signs stable | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 08007 | 0 | IM | LA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Syncope, Tonic clonic movements | | Write-up: Immediately after vaccine administration patient had syncopal episode with tonic posturing fell from table. Responded with gentle stimulation versus normal 5 minutes post regaining full consciousness. |
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| VAERS ID: | 263024 | Vaccination Date: | 2006-09-11 | | Age: | 1.5 | Onset Date: | 0000-00-00 Days later: | | Gender: | Male | Submitted: | 2006-09-11 | | State: | North Carolina | Entered: | 2006-09-13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP | SANOFI PASTEUR | U1751AB | 3 | IM | RL | | HPV4 | MERCK & CO. INC. | | | UN | UN | | PNC | WYETH PHARMACEUTICALS, INC | B08682H | 2 | IM | LL | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Wrong drug administered | | Write-up: Wrong vaccine was given Gardasil was given instead of Hep A by mistake. |
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| VAERS ID: | 263032 | Vaccination Date: | 2006-07-07 | | Age: | 15.0 | Onset Date: | 2006-07-20 Days later: 13 | | Gender: | Female | Submitted: | 2006-08-24 | | State: | Illinois | Entered: | 2006-09-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? Yes, 1 days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Adderall | | Preexisting Conditions: Attention deficit disorder. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | UN | | MNQ | SANOFI PASTEUR | U2069AA | 0 | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity | | Write-up: Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos. Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent. Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened. Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair. Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP. Exam showed definite weakness of all extremities, esp upper extremities, & neck. Reflexes were absent in legs. Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help. Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records. Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT. Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands. Now able to rise from sitting on floor w/o support. Still no reflexes in legs. Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss |
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| VAERS ID: | 263185 | Vaccination Date: | 2006-08-29 | | Age: | 15.0 | Onset Date: | 2006-08-29 Days later: 0 | | Gender: | Female | Submitted: | 2006-08-31 | | State: | New York | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Singulair, Allegra, Flovent, Rhinocort | | Preexisting Conditions: Asthma, Penicillin allergy. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dysphagia | | Write-up: 2 hours after Gardasil Administration pt developed inability to swallow. Advised to take Benadryl by covering physician and go to ER. In ER not given EPI but Solumedrol to take for 5 days. |
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| VAERS ID: | 263200 | Vaccination Date: | 2006-07-25 | | Age: | | Onset Date: | 2006-07-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA00410 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a pharmacist concerning her daughter who on approximately 25-JUL-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). On approximately 25-JUL-2006 the patient experienced soreness at the injection site that lasted approximately one week and at the time of this report had not resolved. Additional information has been requested. |
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| VAERS ID: | 263201 | Vaccination Date: | 2006-08-02 | | Age: | | Onset Date: | 2006-08-02 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | New York | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA01129 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a registered nurse concerning a female who on 02-AUG-2006 was vaccinated with the first dose of HPV rLi 3 11 16 18 VLP vaccine (yeast). It was reported that the patient fainted "shortly after receiving the vaccination". The nurse did not feel the experience was vaccine related and stated "the patient was very uneasy with the idea of an injection". The patient subsequently recovered "shortly after fainting". Unspecified medical attention was sought. Additional information has been requested. |
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| VAERS ID: | 263202 | Vaccination Date: | 2006-08-03 | | Age: | 14.0 | Onset Date: | 2006-08-04 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Colorado | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: CLARITIN, vitamins (unspecified) | | Preexisting Conditions: MEDICAL HISTORY: fever, CONCURRENT CONDITIONS: seasonal allergy | | CDC 'Split Type': WAES0608USA01355 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pruritus, Rash, Rash papular, Skin burning sensation, Skin ulcer | | Write-up: Information has been received from a registered nurse concerning a 14 year old female with seasonal allergies who was exposed to roseola on 25-JUL-2006 and had a fever on 02-AUG-2006. On 03-AUG-2006, the patient was vaccinated intramuscularly with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653937/0637F). Concomitant therapy included loratadine (CLARITIN) and vitamins (unspecified). On 04-AUG-2006, the patient developed an extensive rash. The patient discovered the rash at 7 am on the back of her legs. It was reported that the rash spread to her back and shoulders and had started to spread to her abdomen. The rash consisted of non vesicular papular single lesions that were slightly larger than a pinpoint and too numerous to count. The lesions were described as "burning and itchy". Unspecified medical attention was sought. At the time of the report, the patient's rash persisted. Additional information has been requested. |
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| VAERS ID: | 263203 | Vaccination Date: | 2006-08-09 | | Age: | 26.0 | Onset Date: | 2006-08-09 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Texas | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA02569 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Arthralgia, Influenza like illness, Nausea, Pain, Pyrexia | | Write-up: Information has been received form a physician concerning a 29 year old female with no pertinent medical history and no history of drug reactions allergies who on 8/9/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653937/0637F) inappropriate schedule of vaccina administration. There was no concomitant medication. On 8/9/06 the pt experienced a fever, nausea, body aches, joint pains and experienced flu like symptoms. Unspecified medical attention was sought. At the time of this report, the pt was recovering from the fever, nausea, body aches, joint pains and flu like symptoms. |
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| VAERS ID: | 263204 | Vaccination Date: | 2006-07-18 | | Age: | 21.0 | Onset Date: | 2006-07-18 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Kentucky | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Blood pressure 7/18/06 130/80 records received 7/18/07-Positive yeast vaginal culture. BX on 5/30/07-mild sysplasia/HPV | | Previous Vaccinations: | | Other Medications: Ortho Tri cyclen Lo | | Preexisting Conditions: Pap smear abnormal, Dysplasia, Breast Prosthesis user. 7/18/07-records received-HX papular condyloma. | | CDC 'Split Type': WAES0608USA02804 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0640F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Anogenital warts, Biopsy cervix abnormal, Deafness, Dizziness, Dysarthria, Injection site pain, Musculoskeletal pain, Musculoskeletal stiffness, Pallor, Papilloma viral infection, Paraesthesia, Shock, Skin papilloma, Speech disorder, Syncope, Tinnitus, Vaginal candidiasis, Vision blurred | | Write-up: Initial and follow up information has been received from a 21 year old female with breast implants and had a history of abnormal pap test and dysplasia and from a nurse practitioner. On 7/18/06 the pt was vaccinated with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0640F). Concomitant therapy included ethinyl estradiol + norgestimate (Ortho Lo). On 7/18/06, immediately following vaccination, the pt experienced slurred speech for approx 3 to 4 minutes and reported that she felt as if her body went into shock. She noted that her fingers curled into a fist and her fingers and hands stiffened up. She reported that the later symptoms lasted for approx 25 to 30 minutes. Also approx two weeks after receiving the vaccination, she began to have some pain and stiffness in her upper left arm and shoulder in the same arm she had received the injection. Unspecified medical attention was sought. At the time of this report, the pain and stiffness in the left arm and shoulder had not resolved. The pt also reported that although she had never had nay type of genital warts in the past, on approx 8/4/06 she noted she had small genital warts which were confirmed by her health care professional. In follow up th nurse practitioner reported conflicting information that what the pt described was not what she and another nurse witnesses. The nurse practitioner stated that following the injection the pt appeared pale and almost fainted. The pt became woozy and could speak clearly. The pt was attended to by both the nurse practitioner and another nurse. The pt was diagnosed with having a near syncopal episode. The pt was treated with a cool compress and she recovered quickly and was noted as fine afterwards. The pts blood pressure was fine noted at 130/80 mmHg. it was reported that the pt did not experience any drop in hart rate, did not loose consciousness, did not seize and did not experience wheezing. The nurse practitioner did not see what she would describe as any adverse reaction to the vaccines and described th |
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| VAERS ID: | 263205 | Vaccination Date: | 2006-08-08 | | Age: | | Onset Date: | 2006-08-11 Days later: 3 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0608USA02806 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness | | Write-up: Information has been received from a nurse concerning two female pts (WAES0609USA01112) who on approx 8/8/06 were vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (lot not provided). It was reported that after receiving the vaccinations both pts fainted. Additional information regarding the pts was not provided. Additional information has been requested. |
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| VAERS ID: | 263206 | Vaccination Date: | 2006-08-14 | | Age: | 18.0 | Onset Date: | 2006-08-14 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Tennessee | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: body temperature 08/14/06 "low grade fever" | | Previous Vaccinations: | | Other Medications: (therapy unspecified) | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA03642 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Myalgia, Nausea, Pyrexia, Vomiting | | Write-up: Information has been received from a physician concerning an 18 year old who on 14-AUG-2006 was vaccinated (yeast). Concomitant therapy included an unspecified therapy ("ESTRASTEP"). On 14-AUG-2006 the patient experienced profuse nausea, vomiting, low grade fever and myalgia. The patient sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 263207 | Vaccination Date: | 2006-08-08 | | Age: | 20.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: ORTHO TRI CYCLEN | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA03841 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Diarrhoea | | Write-up: Information has been received from a nurse practitioner concerning a 20 year old female who on 08-AUG-2006 was vaccinated with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). Following the vaccination, on an unspecified date in August 2006, the patient experienced diarrhea. Unspecified medical attention was sought. At the time of this report, the outcome of the diarrhea was unknown. Additional information has been requested. |
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| VAERS ID: | 263208 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-09-14 | | State: | New Jersey | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0608USA03934 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Urticaria | | Write-up: Information has been received from a physician concerning a pt who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. Subsequently the pt experienced hives. No further details were provided, and at the time of this report, the outcome of the event was unknown. Additional information has been requested. |
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| VAERS ID: | 263209 | Vaccination Date: | 2006-08-15 | | Age: | 19.0 | Onset Date: | 2006-08-15 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Pennsylvania | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Tuberculin skin test | | Previous Vaccinations: | | Other Medications: (therapy unspecified) | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA03961 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Dizziness | | Write-up: Information has been received from a nurse concerning a 19 year old female with no pertinent medical history or drug reactions allergies who on 8/15/06 was vaccinated IM with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0702F). Concomitant therapy included Menactra. On an unspecified date the pt was given tuberculin purified protein derivative. On 8/15/06, 5 minutes after vaccination with HPV rL1 6 11 16 18 VLP vaccine yeast, the pt became faint. The pt was given water and chocolate as treatment. Subsequently, the pt recovered on 8/15/06. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a nurse concerning a 19 year old female patient with no pertinent medical history or drug reactions/allergies who on 15-AUG-2006 at 9:00 AM was vaccinated intramuscularly with the first dose of GARDASIL (lot #653650/0702F). Concomitant therapy included "MENACTRA". On an unspecified date the patient was given tuberculin purified protein derivative. On 15-AUG-2006, within 10 minutes of receiving the vaccination, the patient became very faint and sweaty which lasted for approximately 60 seconds. The patient remained in the office for 45 minutes and was given water and chocolate as treatment. Subsequently, the patient recovered on 15-AUG-2006. No further information is expected. |
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| VAERS ID: | 263210 | Vaccination Date: | 2006-08-15 | | Age: | 20.0 | Onset Date: | 2006-08-15 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Pennsylvania | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: WELLBUTRIN, PEPCID, PAXIL | | Preexisting Conditions: CONCURRENT CONDITIONS: Penicillin allergy, drug hypersensitivity | | CDC 'Split Type': WAES0608USA03962 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a nurse concerning a 20 year old female with a penicillin allergy, drug hypersensitivity to cefaclor (CECLOR) and no other pertinent medical history reported. On 15-AUG-2006, the patient was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0702F). Concomitant therapy included paroxetine HCL (PAXIL), bupropion HCL (WELLBUTRIN) and famotidine. It was reported that the patient became faint within 5 minutes of vaccination with HPV rLi 6 11 16 18 VLP vaccine (yeast). The patient was given a soda to drink as treatment. There were no laboratory diagnostic studies performed. On 15-AUG-2006, the patient recovered from the event. Additional information has been requested. |
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| VAERS ID: | 263211 | Vaccination Date: | 2006-08-11 | | Age: | 19.0 | Onset Date: | 2006-08-12 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Florida | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: (therapy unspecified) | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA03973 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | | |
| Administered by: Private Purchased by: Other | | Symptoms: Pain | | Write-up: Initial and follow up has been received from a healthcare worker in a physician's office concerning her 19 year old daughter who was a student and an unspecified person at the physician's office. On 11-AUG-2006, at 11:15 am, the patient was vaccinated intramuscularly in the deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0702F). Other concomitant therapy included an unspecified therapy ('LO-L"). On 12-AUG-2006 (previously reported as 14-AUG-2006) the patient developed pain in her right arm and ribcage on the same side where the vaccine was administered. On 16-AUG-2006, the patient had recovered from the events. No further information is available. |
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| VAERS ID: | 263212 | Vaccination Date: | 2006-08-14 | | Age: | 19.0 | Onset Date: | 2006-08-14 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Arkansas | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA04253 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0689F | | SC | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pruritus, Rash | | Write-up: Information has been received from a registered nurse concerning a 19 year old female with no pertinent medical history or drug reactions/allergies who on 14-AUG-2006 was vaccinated subcutaneously with "the standard dose" of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653736/0689F). There was no concomitant medication. ON 15-AUG-2006 the patient developed a rash on her face and experienced itching on her face. It was reported that the rash was only on the patient's face and not at the injection site or any other part of her body. The patient was instructed to take diphenhydramine hydrochloride (BENADRYL). On 17-AUG-2006, in the morning, the patient was instructed to take diphenhydramine hydrochloride (BENADRYL). On 17-AUG-2006, in the morning, the patient called her physician's office and reported that "it was responding to diphenhydramine hydrochloride (BENADRYL) but had not fully recovered". The patient was scheduled to be seen by her physician on 17-AUG-2006. Additional information has been requested. |
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| VAERS ID: | 263213 | Vaccination Date: | 2006-08-17 | | Age: | 14.0 | Onset Date: | 2006-08-17 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Pennsylvania | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA04330 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | AR | |
| Administered by: Private Purchased by: Other | | Symptoms: Loss of consciousness | | Write-up: Information has been received from a physician concerning a 14 year old female with no pertinent medial history or drug reactions/allergies, who on 17-AUG-2006 was vaccinated intramuscularly with HPV rLI 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). There was no concomitant medication. On 17-AUG-2006, 15 minutes after receiving the vaccination, the patient "passed out" in the car on her way home. The patient was driven back to the physician's office, where she "woke up and was given soda and cold compresses". There was no reactions at the injection site and the patient had no additional reactions. Additional information has been requested. 01/05/2007 Initial and follow-up information has been received from a physician concerning a 14 year old female with no pertinent medical history or drug reactions/allergies, who on 17-AUG-2006 at 10:00 AM was vaccinated intramuscularly in the arm with the first dose of GARDASIL (lot # 653650/0702F). There was no concomitant medication and no illnesses a time of vaccination. On 17-AUG-2006, at 10:10 AM, the patient "passed out" in the car on her way home. It was reported that following vaccination, the patient went to her car and as her mother was driving, the patient passed out. The mother drove right back to the physician's office with the patient, and the patient was carried into the office by a physician at which time she was awake. The patient lied down and was given soda and a cold compress to her forehead. It was reported that the "patient was only out a matter of 2 minutes before coming to". There was no reaction at the injection site and the patient had no additional reactions. No further information is expected. |
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| VAERS ID: | 263214 | Vaccination Date: | 2006-08-16 | | Age: | 18.0 | Onset Date: | 2006-08-16 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Massachusetts | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA04456 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a registered nurse concerning an 18 year old female who on 16-AUG-2006 was vaccinated intramuscularly in the deltoid with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml). The patient subsequently experienced severe injection site pain. It was reported that the patient remarked that the injection really hurt and that the pain flew down her arm. The patient rubbed her arm for a few minutes after receiving the injection. The patient subsequently went home and the nurse had not heard back from the patient. The patient was to be followed by her physician's office. The nurse also reported that she had not agitated the syringe prior to injection. At the time of this report, the outcome of the event was unknown. Additional information has been requested. |
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| VAERS ID: | 263215 | Vaccination Date: | 2006-08-10 | | Age: | 18.0 | Onset Date: | 2006-08-10 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: TRINESSA | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA04457 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Vomiting | | Write-up: Information has been received from a physician concerning an 18 year old female with no pertinent medical history or drug reactions/allergies, who on 10-AUG-2006 was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (TRINESSA). On 10-AUG-2006 the patient experienced multiple episodes of vomiting. Unspecified medical attention was sought. Subsequently, the patient recovered from the vomiting within 48 hours. Additional information has been requested. |
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| VAERS ID: | 263216 | Vaccination Date: | 2006-08-17 | | Age: | 15.0 | Onset Date: | 2006-08-17 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA04465 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Nausea | | Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 17-AUG-2006 was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml) (lot#653650/0702F). There was no concomitant medication. On 17-aug-2006 the patient experienced nausea. Unspecified medical attention was sought. At the time of this report, the patient's nausea persisted. Additional information has been requested. |
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| VAERS ID: | 263217 | Vaccination Date: | 2006-08-18 | | Age: | 18.0 | Onset Date: | 2006-08-18 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Massachusetts | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA04485 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain, Syncope | | Write-up: Information has been received from a nurse concerning an 18 year old female with no known allergies and no other pertinent medical history reported. On 18-AUG-2006, the patient was vaccinated intramuscularly in the deltoid with a 0.5 ml "single dose prefilled syringe" of HPV rLi 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0702F). There were no concomitant medication reported. On 18-AUG-2006, the patient developed severe injection site pain with HPV rLi 6 11 16 18 VLP vaccine (yeast) injection. The patient remarked that "it hurt and felt that the injection went to her head". The nurse reported that the patient felt faint immediately after the vaccination. The nurse had the patient lay down. It was reported that the patient "got up after 1 minute and said that she was ok.". The nurse reported that the "patient left the office immediately after this and the nurse was following up with the patient later today to make sure that the patient was ok." The nurse reported that she had not agitated the syringe prior to injection. The patient sought unspecified medical attention. There were no laboratory diagnostic studies performed. On 18-AUG-2006, the patient recovered from the events. Additional information has been requested. |
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| VAERS ID: | 263218 | Vaccination Date: | 2006-07-27 | | Age: | 52.0 | Onset Date: | 2006-07-27 Days later: 0 | | Gender: | Female | Submitted: | 2007-01-06 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Herpes labialis | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Herpes virus infection | | CDC 'Split Type': WAES0608USA04520 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Private Purchased by: Other | | Symptoms: Injection site reaction | | Write-up: This is in follow-up to report(s) previously submitted on 9/14/2006. Initial and follow-up information has been received from a physician concerning a 52 year old female with a history of a "herpes outbreak" two weeks ago. On 17-JUL-2006. "10 days prior" to receiving GARDASIL (yeast), the patient had taken acyclovir 200 mg. On 27-JUL-2006, the patient was vaccinated intramuscularly with the first dose of 0.5 mL of GARDASIL (yeast). It was reported that the patient had "2 herpes lesions on her inner labia" at the time of vaccination. On 27-JUL-2006, the patient developed a neck ache, eyelashes fell out, "a decrease memory for people" and excessive dry eye. On 27-AUG-2006 the patient developed a migraine with vomiting (previously reported that the patient had "burning at the injection site"). The patient sought unspecified medical attention. At the time of this report, the patient had recovered from the events (date unknown). Additional information has been requested. |
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| VAERS ID: | 263219 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA05355 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Influenza like illness | | Write-up: Information has been received from a physician concerning a female (age not reported) who on an unspecified date, was vaccinated intramuscularly with the first dose of 0.5 ml of HPV rLi 6 11 16 18 VLP vaccine (yeast). The day after receiving HPV rLi 6 11 16 18 VLP vaccine (yeast), the patient developed "flu-like symptoms" (date unknown). The patient sought unspecified medical attention. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested. |
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| VAERS ID: | 263220 | Vaccination Date: | 2006-08-21 | | Age: | 22.0 | Onset Date: | 2006-08-21 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Illinois | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: ORTHO TRI CYCLEN | | Preexisting Conditions: CONCURRENT CONDITIONS: drug hypersensitivity | | CDC 'Split Type': WAES0608USA05414 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Loss of consciousness | | Write-up: Information has been received from a 22 year old female with an allergy to meperidine hydrochloride (DEMEROL) who on 21-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). On 21-AUG-2006, following the vaccination, the patient fainted. Unspecified medical attention was sought. At the time of this report, the patient was recovering. Additional information has been requested. |
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| VAERS ID: | 263221 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Arizona | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00390 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 1 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site vesicles | | Write-up: Information has been received from a registered nurse concerning a female patient who in 2006 was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, she was vaccinated with her second dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, she developed a blister at the injection site. Medical attention was sought. The patient's outcome was unknown. Additional information has been requested. Follow-up informatin received 4-11-08, indicated that the patient was being treated with an unspecified vaccine, and not Gardasil as previously reported. Therefore, WAES #0609USA00390 is being deleted from our files on HPV rL1 6 11 16 8 VLP vaccine (yeast). This report was previously sent to PLA V501 on 09/14/06. |
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| VAERS ID: | 263222 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Arizona | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00391 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 1 | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site vesicles | | Write-up: Information has been received from a registered nurse concerning a female patient who in 2006 was vaccinated with her first dose of GARDASIL. Subsequently, she was vaccinated with her second dose of GARDASIL (yeast). Subsequently, she developed a blister at the injection site. Medical attention was sought. The patient's outcome was unknown. Additional information has been requested. Follow up information indicated that the patient was being treated with an unspecified vaccine, and not GARDASIL as previously reported. Therefore, WAES #0609USA00391 is being deleted from our files on GARDASIL. This report was previously sent to PLA V501 on 14-SEP-2006. |
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| VAERS ID: | 263223 | Vaccination Date: | 2006-08-08 | | Age: | | Onset Date: | 2006-08-11 Days later: 3 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA01112 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Unevaluable event | | Write-up: Information has been received from a nurse concerning two female patients who on approximately 08-AUG-2006 were vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). |
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| VAERS ID: | 263224 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA05808 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a licensed practical nurse concerning female college students 9exact number of patients unspecified) who were vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently the patients experienced injection site (deltoid) pain. At the time of this report, the outcome of the event was unknown. Further attempts are being made to identify the exact number of patients and identifiers of the patients involved in this report. |
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| VAERS ID: | 263225 | Vaccination Date: | 2006-07-19 | | Age: | 15.0 | Onset Date: | 2006-07-19 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Texas | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA06029 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Erythema, Injection site pain, Pain | | Write-up: Information has been receiving from a registered nurse concerning a 15 year old female with no medical history who on 19-JUL-2006 was vaccinated in the right deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653937/0637F). Subsequently, on approximately 19-JUL-2006, the patient experienced burning at the injection site that lasted approximately 60 to 90 seconds and her arm became red and painful enough to cause the patient to cry. The patient subsequently recovered from the pain in the extremity, erythema, and injection site irritation. Additional information has been requested. The registered nurse also reported that the patient's sister experienced pain in the extremity, erythema, and injection site irritation following vaccination with HPV rLi 6 11 16 18 VLP vaccine (yeast) (LOT#653937/0637F). |
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| VAERS ID: | 263226 | Vaccination Date: | 2006-07-27 | | Age: | 21.0 | Onset Date: | 2006-08-03 Days later: 7 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | New York | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06089 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Arthralgia, Pyrexia | | Write-up: Information has been received from a physician concerning a 24 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient's outcome was unknown. Additional information has been requested. 01/05/2007 Follow up information has been received, the physician reported that the patient was recovered from her symptoms and stated "all it was was a one day flu". Additional follow up information has been received from the physician concerning her 24 year old daughter, a student, who on 27-JUL-2006 was vaccinated IM in left arm with her first dose of GARDASIL, lot #653735/0688F. It was reported that on 03-AUG-2006 she developed flu like symptoms. No further information is available. |
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| VAERS ID: | 263227 | Vaccination Date: | 2006-08-07 | | Age: | 20.0 | Onset Date: | 2006-08-07 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Massachusetts | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: YAZ | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA06260 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a 20 year old female patient who on 07-AUG-2006 was vaccinated intramuscularly with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included drospirenone (+) ethinyl estradiol (YAZ). The patient stated that "right after getting the shot" she experienced pain in the upper arm on and off throughout the day. She also stated that the pain"feels like she has a knife in her arm". Unspecified medical attention was sought. The patient was treated with Ibuprofen. As of the report date, she was recovering. Additional information has been requested. |
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| VAERS ID: | 263228 | Vaccination Date: | 2006-08-25 | | Age: | 27.0 | Onset Date: | 2006-08-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Rhode Island | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06297 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Skin burning sensation | | Write-up: Information has been received from a nurse practitioner concerning a 27 year old female who on 25-AUG-2006 was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast), lot#653650/0702F. During the administration of the vaccine, part of the fluid went into the patient's arm, the patient's arm, the patient pulled away and the remainder went on the skin (no adverse reaction noted). The patient complained of burning during administration. Medical attention was sought. The patient received a repeat dose with no burning noted. Patient's status was reported as recovered. Additional information has been requested. |
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| VAERS ID: | 263229 | Vaccination Date: | 2006-07-19 | | Age: | 17.0 | Onset Date: | 2006-07-19 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Texas | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA06310 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Erythema, Pain | | Write-up: Information has been received from a registered nurse concerning a 17 year old female with no medical history who on 19-JUL-2006 was vaccinated in the right deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653937/0637F). Subsequently on approximately site that lasted approximately 60 to 90 seconds and her arm became red and painful enough to cause the patient to cry. The patient subsequently recovered from the pain in the extremity, erythema, and injection site irritation. Additional information has been requested. The registered nurse also reported that the patient's sister experienced pain in the extremity, erythema,and injection site irritation following vaccination with HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653937/0637F). |
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| VAERS ID: | 263230 | Vaccination Date: | 0000-00-00 | | Age: | 19.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | New York | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06470 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Arthralgia, Pyrexia | | Write-up: Information has been received from a physician concerning a 19 year old female patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently,the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient's outcome was unknown. Additional information has been requested. |
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| VAERS ID: | 263231 | Vaccination Date: | 2006-08-01 | | Age: | 18.0 | Onset Date: | 2006-08-01 Days later: 0 | | Gender: | Male | Submitted: | 2006-09-14 | | State: | New York | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06471 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Arthralgia, Pyrexia | | Write-up: Information has been received from a physician concerning an 18 year old male patient who in approximately August 2006, was vaccinated with a dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced pain in joints and developed low grade fever. Unspecified medical attention was sought. The patient's outcome was unknown. Additional information has been requested. Follow up information has been received: the physician reported that the patient was recovered from his symptoms and stated "all it was was a one day flu". Additional information is expected. |
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| VAERS ID: | 263232 | Vaccination Date: | 2006-08-21 | | Age: | 26.0 | Onset Date: | 2006-08-21 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | New Jersey | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: diagnostic laboratory 08/21/2006 "comprehensive metabolic panel tests", electrocardiogram 08/21/06, absolute neutrophil 08/21/06 7.9 K/ul 2.0-609, total urine ketones 08/21/06 >-80 negative, urine bacteria screen 08/21/2006 4+, urine WBC co | | Previous Vaccinations: | | Other Medications: ORTHO TRI CYCLEN | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA06478 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | | UN | |
| Administered by: Public Purchased by: Private | | Symptoms: Laboratory test abnormal, Unevaluable event | | Write-up: Information has been received from an other health professional concerning a 26 year old female in sales with no pre-existing allergies, birth defects or medical conditions reported. On 21-AUG-2006, in the pm, the patient was vaccinated in the left deltoid with the first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702F). Concomitant therapy included ethinyl estradiol/norgestimate (ORTHO TRI CYCLEN). There were no illness noted at the time of vaccination. On 21-AUG-2006, in the pm, the patient experienced an unspecified adverse event. The patient went to the emergency room and it was reported that she "went home that day". On 21-AUG-2006, the patient underwent a complete blood count (CBC), comprehensive metabolic panel, estimated glomerular filtration rate (GFR), urine microscopic analysis, urinalysis and an electrocardiogram (EKG). On 21-AUG-2006, the patient's laboratory data revealed an absolute neutrophil count noted as 7.9 K/ul, urine ketones noted as >-80, a urine white blood cell count noted as 30-40/hpf and urine bacteria noted as 4+. On 21-AUG-2006, the patient recovered from the events. Additional information has been requested. |
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| VAERS ID: | 263233 | Vaccination Date: | 2006-08-07 | | Age: | 26.0 | Onset Date: | 2006-08-07 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Unknown | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0608USA06605 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0696F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Unevaluable event | | Write-up: Information has been received from a 26 year old female licensed practical nurse with no pertinent medical history and no known allergies or adverse drug reactions reported who on 07-AUG-2006 was vaccinated intramuscularly with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (Lot#653650/0696F). There were no concomitant medications reported. The licensed practical nurse reported that she received HPV rLi 6 11 16 18 VLP vaccine (yeast) in her deltoid from a pre-filled syringe. It was reported that when the injection was completed, the nurse administering it "let go of the plunger before taking it out of her arm" and the "spring shot the syringe out of the arm like a dart". It was reported that "some fluid leaked out of her arm". The licensed practical nurse reported that it "stung a little when the vaccine was administered" and then resolved in a few moments. The area of the spill was cleansed with alcohol. The patient sought unspecified medical attention. There were no laboratory diagnostic studies performed. At the time of this report, the patient had recovered from the events. Additional information has been requested. |
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| VAERS ID: | 263234 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Washington | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06614 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a physician concerning a 15 year old female who on an unspecified date was vaccinated intramuscularly with the first dose of 0.5 ml of HPV rLi 6 11 16 18 VLP vaccine (yeast). The patient "fainted after receiving HPV rLi 6 11 16 18 VLP vaccine (yeast)". The patient "fainted after receiving HPV rLi 6 11 16 18 VLP vaccine (yeast). It was reported that the patient had not eaten anything. The patient sought unspecified medical attention. At the time of this report, the patient was recovering from the event. Additional information has been requested. |
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| VAERS ID: | 263235 | Vaccination Date: | 2006-08-18 | | Age: | 23.0 | Onset Date: | 2006-08-23 Days later: 5 | | Gender: | Female | Submitted: | 2007-01-05 | | State: | North Carolina | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06869 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Rash | | Write-up: This is in follow-up to report(s) previously submitted on 9/14/2006. Information has been received from a physician concerning a 23 year old female with no known drug allergies was vaccinated intramuscularly on 18-AUG-2006 at 15:00 in the deltoid muscle with GARDASIL (yeast). On 24-AUG-2006 the patient developed a rash with itching and minimal swelling on the back of her neck, arms, ribs, back and behind her left knee. Follow up information stated that the patient was treated with Benadryl, 50 mg and topical hydrocortisone cream. It was reported that on 24-AUG-2006 the patient had recovered. Additional information is not expected. |
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| VAERS ID: | 263236 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Arizona | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA06941 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 1 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site vesicles | | Write-up: Information has been received from a registered nurse concerning a female patient who in 2006 was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, she was vaccinated with her second dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, she developed a blister at the injection site. Medical attention was sought. The patient's outcome was unknown. Follow-up information received 4-11-08 indicated that the patient was being treated with an unspecified vaccine, and not GARDASIL as previously reported. Therefore, WAES #0608USA06941 is being deleted from our files on HPV rL1 6 11 16 18 VLP vaccine (yeast). This report was previously sent to PLA V501 on 09/14/06. |
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| VAERS ID: | 263237 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-09-14 | | State: | Rhode Island | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0608USA07071 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site reaction | | Write-up: Information has been received from a nurse practitioner concerning an unspecified number of patient's who were vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast) and complained of burning during administration. The patient's outcomes were not reported. Additional information has been requested. |
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| VAERS ID: | 263238 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-09-14 | | State: | Washington | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00001 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | UN | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a physician concerning three patients (age and gender not reported) who on an unspecified date, in the morning, were vaccinated with GARDASIL vaccine. Subsequently, the patients fainted after receiving GARDASIL vaccine (date unknown). It was reported that the patients had not eaten anything. At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 263239 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-09-14 | | State: | North Carolina | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00041 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a registered nurse concerning 3 patients 9age and gender not reported) who on an unspecified date were vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently the patients developed injection site pain (date unknown). The patients sought unspecified medical attention. At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 263240 | Vaccination Date: | 2006-08-30 | | Age: | 26.0 | Onset Date: | 2006-08-30 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: TORADOL | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00066 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Loss of consciousness | | Write-up: Information has been received from a physician concerning a 26 year old female who on 30-AUG-2006 was vaccinated intramuscularly in her right arm with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included ketorolac tromethamine (TORADOL). On 30-aUG-2006, the patient felt "dizzy" after the injection. The patient was then given a ketorolac tromethamine (TORADOL) injection and she "passed out" after receiving that injection (also reported as "dizziness followed by syncope"). It was reported that the patient was seeing the physician or her pain shot. The syncope occurred after her pain injection. The physician believed this was a vaso vagal response. It was reported that "it was not known if the patient was that she was scheduled to receive". The patient sought unspecified medical attention. It was reported that "she did not her second shot yet". On 30-AUG-2006, "a few minutes after", the patient recovered from the events. Additional information has been requested. |
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| VAERS ID: | 263241 | Vaccination Date: | 2006-08-29 | | Age: | 24.0 | Onset Date: | 2006-08-29 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-14 | | State: | Pennsylvania | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Unknown | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Doxycycline; ALLEGRA-D; hormonal contraceptives; AMBIEN | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00077 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0589F | 0 | | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site pain, Injection site swelling | | Write-up: Information has been received from a physician concerning a female patient in her early 20's who was vaccinated with her first dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced a high amount of pain and swelling at the injection site. Medical attention was sought. Subsequently, the patient recovered. Additional information has been requested. 01/05/2007 Follow up information has been received from a physician concerning a 24 year old female who on 29-AUG-2006 at 9:00 a.m. was vaccinated in the left arm with her first dose of GARDASIL, lot #653736/0589F. Concomitant therapy included AMBIEN, doxycycline, ALLEGRA-D, and unspecified oral contraceptive pills. Following the vaccination, on 29-AUG-2006 at 9:00 a.m. the patient experienced pain (burning) in her left arm plus swelling and tenderness x 3 days. Additional information is not expected. |
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| VAERS ID: | 263242 | Vaccination Date: | 0000-00-00 | | Age: | 23.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00264 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Pallor | | Write-up: Information has been received from a physician concerning a 23 year old female. It was reported that it was "not known if the patient was pregnant, if she was taking any other medications or had a history of drug reactions or allergies." On an unspecified date, the patient was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). It was reported that the patient felt "light headed and dizzy" after receiving HPV rLi 6 11 16 18 VLP vaccine (yeast). The patient also "turned very pale", but did not faint. At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 263243 | Vaccination Date: | 0000-00-00 | | Age: | 20.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00265 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a nurse in a physician's office concerning a female patient "in her 20's" who on an unspecified date was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). It was reported that the patient "fainted" after being given HPV rLi 6 11 16 18 VLP vaccine (yeast) (date unknown). At the time of this report, the outcome of the event was unknown. Additional information has been requested. |
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| VAERS ID: | 263244 | Vaccination Date: | 0000-00-00 | | Age: | 20.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-14 | | State: | California | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00266 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a nurse in a physician's office concerning a female patient "in her 20's" who on an unspecified date was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). It was reported that the patient "fainted" after being given HPV rLi 6 11 16 18 VLP vaccine (yeast) (date unknown). At the time of this report, the outcome of the event was unknown. Additional information has been requested. |
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| VAERS ID: | 263256 | Vaccination Date: | 2006-08-29 | | Age: | 22.0 | Onset Date: | 2006-08-31 Days later: 2 | | Gender: | Female | Submitted: | 2006-09-19 | | State: | Maine | Entered: | 2006-09-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: none known | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Celexa 40mg 1 1/2 tabs po q day | | Preexisting Conditions: none known | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0689F | 0 | IM | RA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Fungal infection, Pruritus | | Write-up: About 2 days after administration of Gardasil pt reported onset of intense itching under armpit same side, has now been present for about 3 weeks, not improving. Possibly reaction to Gardasil vs fungal infection -avoid any irritants, no creams of soaps or deodorants -fungal cream twice a day -will report this as adverse event to Gardasil -reeval in 1 week Medications Added to Medication List This Visit: 1) Ketoconazole 2 % Crea (Ketoconazole) .... Apply twice a day |
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| VAERS ID: | 263314 | Vaccination Date: | 2006-08-28 | | Age: | 13.0 | Onset Date: | 2006-08-29 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-19 | | State: | California | Entered: | 2006-09-20 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: Allergic rhinitis, RAD | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | LA | | TDAP | AVENTIS PASTEUR | C2557AA | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Headache, Pyrexia, Rash | | Write-up: On 8/29/06 pt woke up in am to rash on face and fever of 103. Rash not itchy. Treatment Tylenol or Motrin for fever. On 8/30/06 Pt continues with rash on face off and on and also fever continues. Temperature ranging 99.2 - . Also complains of headache. |
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| VAERS ID: | 263332 | Vaccination Date: | 2006-09-18 | | Age: | 12.0 | Onset Date: | 2006-09-19 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-20 | | State: | Wisconsin | Entered: | 2006-09-20 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | RA | |
| Administered by: Private Purchased by: Public | | Symptoms: Arthralgia, Pain | | Write-up: Right hypothenar eminence (thumb) started aching approximately 24 hours after shot administered, then the right wrist ached badly (i.e arthralgia). No other etiology of pain identified. Anaprox DS (Naproxen) and split provided. |
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| VAERS ID: | 263354 | Vaccination Date: | 2006-09-06 | | Age: | 17.0 | Onset Date: | 2006-09-06 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-19 | | State: | Massachusetts | Entered: | 2006-09-21 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Hormonal contraceptions. | | Preexisting Conditions: | | CDC 'Split Type': WAES0609USA02500 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0800F | 0 | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Convulsion, Syncope | | Write-up: Information has been received from a nurse practitioner concerning a 17 year old female with no other pertinent medical history, adverse drug reactions or allergies reported. On 9/6/06, at 3:30pm, the pt was vaccianted IM with the first dose of 0.5ml of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 654540/0800F). Concomitant therapy included an unspecified hormonal contraceptives (also reported as birth control). On 9/6/06, the pt developed a mild seizure right after receiving HPV rL1 6 11 16 18 VLP vaccine yeast. The pt came to and immediately fainted again. The pt sought unspecified medical attention. It was reported that the pt had not eaten anything all day. After eating, the pt felt better. On 9/6/06, the pt had fully recovered from the events. Upon internal review, the mild seizure was considered to be an other important medical event. Additional information has been requested. |
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| VAERS ID: | 263370 | Vaccination Date: | 2006-08-24 | | Age: | 22.0 | Onset Date: | 2006-08-25 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-21 | | State: | Kansas | Entered: | 2006-09-21 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Ortho Tri cyclen LO x 6 years. | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | GM | |
| Administered by: Private Purchased by: Other | | Symptoms: Breast disorder female, Tenderness | | Write-up: Extreme Breast tenderness x 4 days. |
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| VAERS ID: | 263539 | Vaccination Date: | 2006-09-22 | | Age: | 18.0 | Onset Date: | 2006-09-22 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-25 | | State: | California | Entered: | 2006-09-25 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Seasonal | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 1 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Syncope | | Write-up: Pt fainted. |
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| VAERS ID: | 263612 | Vaccination Date: | 2006-09-01 | | Age: | 18.0 | Onset Date: | 2006-09-08 Days later: 7 | | Gender: | Female | Submitted: | 2006-09-25 | | State: | North Carolina | Entered: | 2006-09-26 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Singular, Zyrtec | | Preexisting Conditions: Seasonal allergic rhinitis. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | LA | |
| Administered by: Other Purchased by: Private | | Symptoms: Blister, Erythema, Hypersensitivity, Rash erythematous | | Write-up: Raised erythematous patchy rash of left shoulder (Behind left deltoid muscle) with slight vesicles. Also similar linear rash on left leg (appearance of delayed hypersensitivity) rash began 1 week after injection. |
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| VAERS ID: | 263740 | Vaccination Date: | 2006-09-01 | | Age: | 26.0 | Onset Date: | 2006-09-08 Days later: 7 | | Gender: | Female | Submitted: | 2006-09-21 | | State: | Missouri | Entered: | 2006-09-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Birth Control Seasonal | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Rash pruritic | | Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back. |
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| VAERS ID: | 263743 | Vaccination Date: | 0000-00-00 | | Age: | 26.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-09-21 | | State: | Missouri | Entered: | 2006-09-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Rash pruritic | | Write-up: Itchy bumps 1 on back, 1 on arm, 1 on leg. |
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| VAERS ID: | 263750 | Vaccination Date: | 2006-09-14 | | Age: | 26.0 | Onset Date: | 2006-09-21 Days later: 7 | | Gender: | Female | Submitted: | 2006-09-27 | | State: | Texas | Entered: | 2006-09-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Phentermine 37.5 mg as needed | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0641F | 0 | | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Joint range of motion decreased, Pain | | Write-up: One week post injection, complain of achy arm where injection was given, difficult to raise arm, no swelling or redness at injection site. |
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| VAERS ID: | 263751 | Vaccination Date: | 2006-08-25 | | Age: | 20.0 | Onset Date: | 2006-08-26 Days later: 1 | | Gender: | Female | Submitted: | 2000-09-26 | | State: | New York | Entered: | 2006-09-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Yasmin | | Preexisting Conditions: possible polycystic ovary syndrome | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Other | | Symptoms: Injection site reaction, Rash | | Write-up: Rash at injection site at 24 hours after administration, then rash on other arm (at corresponding site) |
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| VAERS ID: | 263754 | Vaccination Date: | 2006-09-25 | | Age: | 26.0 | Onset Date: | 2006-09-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-25 | | State: | Kentucky | Entered: | 2006-09-29 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: took two BENADRYL | | Previous Vaccinations: | | Other Medications: BUSPAR, ATIVAN, CELEXA | | Preexisting Conditions: Penicillin | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria | | Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands. |
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| VAERS ID: | 263862 | Vaccination Date: | 2006-09-28 | | Age: | 15.0 | Onset Date: | 2006-09-29 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-02 | | State: | Illinois | Entered: | 2006-10-02 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Anorexia, Back pain, Fatigue, Headache, Pyrexia | | Write-up: Fatigue, Headache, Backaches, Temp 103, no appetite, x 3 days then was ok no treatment. |
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| VAERS ID: | 263878 | Vaccination Date: | 2006-10-02 | | Age: | 20.0 | Onset Date: | 2006-10-02 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-02 | | State: | Georga | Entered: | 2006-10-02 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | ? | 0 | IM | LA | |
| Administered by: Public Purchased by: Public | | Symptoms: Dizziness, Nausea | | Write-up: A few minutes after injection, patient began to feel faint and dizzy while standing up. Sitting down did not alleviate symptoms of nausea, so patient was moved to a bed to lie down. After about 10 minutes of laying down, patient was back to normal. |
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| VAERS ID: | 263895 | Vaccination Date: | 2006-09-25 | | Age: | 18.0 | Onset Date: | 2006-09-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-09-29 | | State: | Maine | Entered: | 2006-10-03 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Asthma; Polycystic ovaries; Cold | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: Wellbutrin XL; lithium carbonate; Risperdal | | Preexisting Conditions: Asthma; Polycystic ovaries; cold | | CDC 'Split Type': WAES0609USA06568 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | | IM | LA | |
| Administered by: Other Purchased by: Other | | Symptoms: Swelling face | | Write-up: Initial and follow up information has been received from a registered nurse concerning an 18 year old female with asthma, polycystic ovaries and no known allergies or adverse drug reactions reported. On 25-SEP-2006, the patient was vaccinated intramuscularly with a 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653735/0688F). Concomitant therapy included bupropion HCL (WELLBUTRIN XL), lithium carbonate and risperidone (RISPERDAL). That evening, on 25-SEP-2006, the patient developed left arm swelling and difficulty breathing. It was reported that the difficulty breathing could be due to the patient having a cold and being an asthmatic. On 26-SEP-2006 the patient developed facial swelling. The patient sought unspecified medical attention. It was reported that a nurse practitioner and physician were doing an assessment and consultation. On an unspecified date, the patient had the assessment and consultation and her symptoms were not considered to be serious. At the time of this report, the patient was recovering from th events. The reporter considered the events to be serious as other important medical events (date unknown). Additional information is not expected. |
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| VAERS ID: | 263930 | Vaccination Date: | 2006-09-28 | | Age: | 21.0 | Onset Date: | 2006-09-28 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-03 | | State: | Rhode Island | Entered: | 2006-10-03 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 08001F | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Injection site warmth, Pain, Pyrexia | | Write-up: FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY. |
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| VAERS ID: | 264066 | Vaccination Date: | 2006-09-25 | | Age: | 16.0 | Onset Date: | 2006-09-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-03 | | State: | Wisconsin | Entered: | 2006-10-06 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Prozac, Abilify, Lamictal. | | Preexisting Conditions: allergies, sinusitis, Bipolar disorder. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | | RA | | MNQ | AVENTIS PASTEUR | U2108AA | 0 | | RA | | TDAP | AVENTIS PASTEUR | C2556AA | 0 | | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site induration, Injection site reaction, Injection site warmth | | Write-up: 2 separate reactions Tdap 6x4 1/2" area hot to touch. Induration of biceps upper arm started day of injection given seen in office 9/28/06, Gardasil 3 1/2 x 3" hot to touch started 3 days after shot for both ice and Ibuprophen. |
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| VAERS ID: | 264172 | Vaccination Date: | 2006-10-02 | | Age: | 17.0 | Onset Date: | 2006-10-06 Days later: 4 | | Gender: | Female | Submitted: | 2006-10-09 | | State: | California | Entered: | 2006-10-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | RA | | MNQ | AVENTIS PASTEUR | U2114AA | 0 | IM | LA | | TDAP | AVENTIS PASTEUR | C2559BA | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Pruritus, Urticaria | | Write-up: Urticaria (hives) developed 4 days after vaccines were given covered torso and extremities, extremely itchy. Pt was given Benadryl Zyrtec, Prednisone orally and took a bath with baking soda. |
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| VAERS ID: | 264204 | Vaccination Date: | 2006-09-12 | | Age: | 15.0 | Onset Date: | 2006-09-13 Days later: 1 | | Gender: | Female | Submitted: | 2006-09-22 | | State: | Massachusetts | Entered: | 2006-10-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: At ER 9/13/06 EKG sinus arrhythmia, chest X ray NL, CT head normal, CBC, U/A, Lytes and toxic screen neg NL. | | Previous Vaccinations: | | Other Medications: Lithium, Propanolol, Prozac, Seraguel, Clozapine, Ritalin, Aviane, Keflex. | | Preexisting Conditions: Bipolar DS, ADHS, left hydronephrosis. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Coma, Mental impairment, Sinus arrhythmia, Urticaria | | Write-up: 09/13/06 pt went to school where she developed hives at 10am. She was sent home, mom came home and found pt unresponsive and called 911. Pt seen at ER. Became responsive and talking well at ER. Exam WNL. DX'd changed mental status sent home. |
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| VAERS ID: | 264209 | Vaccination Date: | 2006-09-27 | | Age: | 12.0 | Onset Date: | 2006-09-27 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-02 | | State: | Unknown | Entered: | 2006-10-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | B229AA | 0 | IM | RA | | IPV | AVENTIS PASTEUR | Y1067 | 1 | IM | LA | | MMRV | MERCK & CO. INC. | 0816F | 0 | IM | RA | | TDAP | AVENTIS PASTEUR | AC52B002AA | 4 | IM | LA | |
| Administered by: Public Purchased by: Public | | Symptoms: Cellulitis, Injection site reaction | | Write-up: Cellulitis at injection site |
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| VAERS ID: | 264366 | Vaccination Date: | 0000-00-00 | | Age: | 19.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Texas | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00433 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain, Joint range of motion decreased | | Write-up: Information has been received from a physician concerning a 19 year old female who in early August 2006, was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast) (0.5 ml). The physician reported that at the time of vaccination, the patient experienced injection site pain. The patient later experienced decreased range of motion in the arm she received the vaccination. It was reported that the patient's arm hurt when she raised it above her head. At the time of this report, the patient's injection site pain, decreased range of motion in arm pain persisted. Unspecified medical attention was sought. Additional information has been requested. |
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| VAERS ID: | 264367 | Vaccination Date: | 2006-09-01 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Unknown | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Unknown | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: Unknown | | CDC 'Split Type': WAES0609USA00663 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a nurse concerning a female who on 01 Sep 2006 was vaccinated intramuscularly with HPV rLi 6 11 16 18 VLP vaccine (yeast) (lot#653650/0702P). The nurse reported that she was very unhappy with the syringe. The nurse reported that she "had received no instructions, and upon using the syringe for the first time, the safety device activated as soon as she pushed all the way down on the plunger, and it hit the patient in the arm". The nurse also reported that she had not read the product insert prior to administering the vaccine, as it was not available in the carton, and as soon as she administered the full dose of vaccine, she immediately let go of the plunger. She also reported that "it was loud, which scared the patient, and the needle coil sprang out and hurt the patient. The patient was kept in the office longer than normal since the coil hit the patient against her arm and hurt her. Unspecified medical attention was sought. The nurse was able to administer the entire dose of vaccine. On 05-Sep-2006 the patient had recovered. |
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| VAERS ID: | 264368 | Vaccination Date: | 2006-08-31 | | Age: | 23.0 | Onset Date: | 2006-08-31 Days later: 0 | | Gender: | Female | Submitted: | 2007-01-05 | | State: | Oregon | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA00688 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0800F | 0 | IM | UN | |
| Administered by: Private Purchased by: Other | | Symptoms: Injury, Medication error | | Write-up: Information has been received from a medical assistant concerning a 23 year old female with no pertinent medical history or drug reaction/allergies, who on 8/31/06 was vaccinated IM with a pre filled syringe HPV rL1 6 11 16 18 VLP vaccine yeast (lot 654540/0800F). There was no concomitant therapy. The medical assistant reported that the spring action activated so forceful the needle and spring popped out of the clients left arm and scratched her. It was reported that all the vaccine was administered and that the pts left arm was washed with soap and water. She also reported that the pt did not bleed. No further details were provided. Additional information has been requested. This is in follow-up to report (s) previously submitted on 10/6/2006. Initial and follow-up information has been received from a medical assistant concerning a 23 year old white female with no partinent medical history of drug reactions/allergies, who on 31-AUG-2006 at 2:00 PM was vaccinated intramuscularly in the left deltoid with the first dose of a pre-filled syringe of GARDASIL (Lot # 654540/0800F). There was no concomitant therapy and no illnesses at time of vaccination. The medical assistant reported that "when the needle safety device was activated, it came down so forceful that the needle and syringe popped out of the client's left arm, struck the patient, and scratched her." The reporter stated that the "syringe deployed as it should have, but was unexpected" by the health care provider. It was reported that the plunger was released before removing the needle from the arm of the patient. The reporter stated that there was no damage noted to the syringe. It was reported that all of the vaccine was administered and that the patient's left arm was washed with soap and water and a bandaid was placed over the puncture site and scratch. The reporter also stated that the patient did not bleed and taht there was no adverse reaction to the patient. The patient subsequently recovered. No further information is expected. |
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| VAERS ID: | 264369 | Vaccination Date: | 2006-08-22 | | Age: | | Onset Date: | 2006-08-23 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Unknown | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA00704 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Urticaria | | Write-up: Information has been received from a registered nurse concerning a female pt (age not provided) who on approx 8/22/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (lot not provided). The nurse reported that a day and half after receiving the vaccine, on approx 8/23/06 the pt developed what appeared to be hives. Unspecified medical attention was sought. Subsequently, the p0t recovered from the hives. Additional information has been requested. |
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| VAERS ID: | 264370 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Wisconsin | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01030 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a physician concerning a female (age not reported) who on an unspecified date was vaccinated with the first dose of 0.5 ml of HPV rL1 6 11 16 18 VLP vaccine yeast. It was reported that the pt fainted after the injection (date unk). The pt sought unspecified medical attention. AT the time of this report, the pt had recovered from the event (date unk). Additional information has been requested. |
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| VAERS ID: | 264371 | Vaccination Date: | 2006-08-16 | | Age: | 13.0 | Onset Date: | 2006-08-16 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Texas | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01051 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a physician concerning her 13 year old daughter who on approx 8/16/06, (also reported as within the past 2-3 weeks) was vaccinated with a 0.5ml dose of HPV rL1 6 11 16 18 VLP vaccine yeast. the physician reported that her daughter experienced soreness at injection site for a couple of days after receiving HPV vaccine. The pt sought unspecified medical attention. At the time of this report, the outcome of the event was unk. Additional information has been requested. |
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| VAERS ID: | 264372 | Vaccination Date: | 2006-09-07 | | Age: | 28.0 | Onset Date: | 2006-09-07 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Montana | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Ortho Tri Cyclen | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA01437 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0689F | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dysgeusia, Hyperhidrosis, Nausea | | Write-up: Information has been received from a licensed practical nurse concerning a 27 year old female with no pertinent medical history or drug reactions. allergies, who on 9/7/06 was vaccinated IM with HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653736/0689F). Concomitant therapy included ethinyl Estradiol norgestimate (Ortho Tri Cyclen). On 9/7/06, immediately after receiving the vaccine, the pt experienced a metallic taste in her mouth, nausea and sweating. The nurse had the pt lay down for a little while and the pt started to feel better. No further details were provided. At the time of this report, the pt was recovering. Additional information has been requested. |
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| VAERS ID: | 264373 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | California | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Body temp between 99 and 103 degrees. | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01470 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | DTAP | UNKNOWN MANUFACTURER | | | | UN | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Pyrexia, Rash, Rash macular | | Write-up: Information has been received from a physician concerning a female who on an unspecified date was vaccinated IM with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy included Dtap. The day after vaccination with HPV the pt developed a blotchy rash which lasted for three days (site of rash not specified). It was also reported that the pt experienced a fever with a temp between 99 and 103 degrees during the same three day period. Unspecified medical attention was sought. At the time of this report, the pt was recovering from the rash and fever. Additional information has been requested. |
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| VAERS ID: | 264374 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Washington | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01524 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Hypoxia | | Write-up: Initial and follow up information has been received from a physician concerning a female pt (age not reported) who on an unspecified date, in the morning, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (date unknown). It was reported that the pt felt dizzy and was administered oxygen. The pt was observed for 30 minutes (previously reported that the pt had not eaten anything. At the time of this report, the pt had recovered from the events (date unk). The physician assessed the events as non serious and reported that she was unsure of the causality of the events. No further information is available. |
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| VAERS ID: | 264375 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Washington | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01525 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Syncope | | Write-up: Initial and follow up information has been received from a physician concerning a female pt (age not reported) who on an unspecified date, in the morning, was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. Subsequently, the pt fainted after receiving HPV vaccine (date unk). It was reported that the pt felt dizzy and was kept for observation (previously reported that the pt had no eaten anything). At the time of this report, the pt had recovered from the events (date unk). The physician assessed the events as non serious and reported that she was unsure of the causality of the events. No further information is available. |
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| VAERS ID: | 264376 | Vaccination Date: | 2006-08-30 | | Age: | 22.0 | Onset Date: | 2006-09-02 Days later: 3 | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Arizona | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Body temp 9/6/06 102F, body temp 9/8/06 98.9F. | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA01979 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Aphthous stomatitis, Herpes simplex, Malaise, Myalgia, Nausea, Pharyngolaryngeal pain, Pyrexia, Skin ulcer, Vomiting | | Write-up: Information has been received from a physician concerning a 22 year old female with no pertinent medical history and no allergies, who on 8/30/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. On 9/2/06 the pt developed a canker sore on her lip and sore throat. On 9/6/06 she experienced nausea, vomiting, malaise, a temperature of 102F and developed a herpetic ulcerative ring on her left ring finger. It was also reported that the pt experienced myalgia. Unspecified medical attention was sought/ Subsequently, it was reported on 9/8/06 that the symptoms were subsiding, the lesion on the pts lip had crusted and her temp was 98.9F. |
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| VAERS ID: | 264377 | Vaccination Date: | 2006-09-05 | | Age: | 19.0 | Onset Date: | 2006-09-06 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-06 | | State: | Missouri | Entered: | 2006-10-11 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Ortho Tri Cyclen | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA02094 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Skin discolouration, Sunburn | | Write-up: Information has been received from a certified medical assistant concerning a 19 year old female with no pertinent medical history and no known allergies or adverse drug reactions reported. On 9/5/06, the pt was vaccinated IM with one dose of HPV rL1 6 11 16 18 VLP vaccine yeast. Concomitant therapy included Ortho Tri Cyclen. It was reported that the pt woke up the next morning and her skin was pink from head to toe. There was no rash, no pain, no itching, no swelling and no hives. It was reported that her only symptom was a sunburn like appearance to her skin. the pt sought unspecified medical attention. On 9/7/06 in the evening, the color began to subside. As of 9/8/06 her skin was reported as looks better and the pt was noted as recovering. Additional information has been requested. |
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| VAERS ID: | 264556 | Vaccination Date: | 2006-10-05 | | Age: | 16.0 | Onset Date: | 2006-10-05 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Indiana | Entered: | 2006-10-16 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | AVENTIS PASTEUR | U2239AA | 1 | | LA | | HEP | MERCK & CO. INC. | 0223F | 1 | | LA | | HPV4 | MERCK & CO. INC. | 0955F | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Injection site pain | | Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days. |
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| VAERS ID: | 264585 | Vaccination Date: | 2006-10-10 | | Age: | 22.0 | Onset Date: | 2006-10-10 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-16 | | State: | Kentucky | Entered: | 2006-10-16 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0868F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Dizziness, Hyperhidrosis, Nausea, Pallor, Peripheral coldness | | Write-up: Pt experienced paleness, sweating, cold hands, nausea, dizziness and lightheadedness. |
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| VAERS ID: | 264674 | Vaccination Date: | 2006-09-14 | | Age: | 18.0 | Onset Date: | 2006-09-14 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Texas | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0610USA04329 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Dyspnoea, Pyrexia | | Write-up: Information has been received from a physician concerning an 18 year old female who on 14-SEP-2006 was vaccinated intramuscularly with a first 0.5 ml dose of HPV rLi 6 11 16 18 VLP vaccine (yeast). About an hour after receiving the vaccine, the patient developed shortness of breath and a fever. The patient was directed to the emergency room. It was noted that the patient's symptoms improved "on therapy" (unspecified). No product quality compliant was involved. Shortness of breath and fever were considered to be other important medical events. Additional information has been requested. (OMIC) |
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| VAERS ID: | 264675 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-10-13 | | State: | Texas | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0610USA05710 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Abdominal pain, Hepatitis | | Write-up: Information has been received from a physician concerning a pt who was vaccinated with a dose of HPV vaccine yeast. Subsequently the pt experienced a recurrence of hepatitis and abdominal pain. The physicians office manager reported that the pt tested positive for hepatitis after receiving the vaccine. The pts outcome was not reported. Recurrence of hepatitis and abdominal pain were considered to be other important medical events (OMIC). Additional information has been requested. |
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| VAERS ID: | 264688 | Vaccination Date: | 2006-10-03 | | Age: | 16.0 | Onset Date: | 2006-10-04 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-12 | | State: | Florida | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0610USA03769 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dyspnoea, Myalgia, Pyrexia | | Write-up: Information has been received from a physician concerning a 16 year old female who on 10/3/06 was vaccinated with 0.5ml of HPV. On 10/4/06, the pt developed muscle aches, fever and shortness of breath. The pt went to the ER. It was unknown if the pt was hospitalized. At the time of this report, the outcome of the event was unknown. The physician considered the events to be serious as other important medical events (OMIC). Additional information has been requested. |
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| VAERS ID: | 264695 | Vaccination Date: | 2006-08-30 | | Age: | 18.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0609USA02204 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a physician assistant concerning an 18 year old female with on 8/30/06 was vaccinated with the first dose of HPV (lot 653650/0702F). The physician assistant reported that the pt received the first dose of HPV, about 12 days ago, and she still experiencing injection site pain. The pt sought unspecified medical attention. It was reported that the pt was being treated with ibuprofen (Advil). At the time of this report, the pt had not recovered from the event. The reporter considered the event to be serious as an other important medical event (OMIC). Additional information has been requested. |
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| VAERS ID: | 264696 | Vaccination Date: | 2006-09-27 | | Age: | | Onset Date: | 2006-09-27 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Hampshire | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': WAES0609USA07424 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | | TTOX | UNKNOWN MANUFACTURER | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain, Medication error | | Write-up: Information has been received from a registered nurse concerning a female (age not reported) with on known allergies or adverse drug reactions reported. On 9/27/06, the pt was vaccinated IM in the left deltoid with 1 ml (2 vials) of HPV vaccine (lot 0B37F). Concomitant therapy included a tetanus toxoid shot in the other arm. Subsequently, the pt experienced arm hurting. The registered nurse confirmed that the pain was at the injection site. The pt has not mentioned any other symptoms. The pt sought unspecified medical attention. The intervention to prevent serious criteria was 800 mg, of Motrin. The registered nurse reported that she did not know if the event would have worsened or improved without the intervention of Motrin. On 9/28/06, the pt returned to the physicians office and was fine, however her arm still hurt. At the time of this report, the pt had not recovered from the event. The reporter considered the event to be serious as an other important medical event (OMIC). Additional information has been requested. |
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| VAERS ID: | 264703 | Vaccination Date: | 2006-10-11 | | Age: | | Onset Date: | 2006-10-12 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-12 | | State: | Massachusetts | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Ortho tricylen | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0955F | 1 | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Acne, Rash | | Write-up: Rash/Pimple like on fact and neck. |
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| VAERS ID: | 264738 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | | Submitted: | 2006-10-13 | | State: | Texas | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA01527 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Initial and follow up information has been received from a physician and a registered nurse in the physicians office concerning a pt (age and gender not reported) who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast. The physician reported that the pt experienced soreness, pain at injection site after receiving HPV. The registered nurse reported that she had spoken with the physician who felt that the soreness was not really a reaction or a problem. It was reported that the physician did not feel it was an adverse effect, just soreness at the injection site. At the time of this report, the outcome of the event was unk. Additional information has been requested. |
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| VAERS ID: | 264739 | Vaccination Date: | 2006-08-30 | | Age: | 13.0 | Onset Date: | 2006-09-09 Days later: 10 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New York | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Vaginal gram stain vaginal swab came back positive for yeast. | | Previous Vaccinations: | | Other Medications: Insulin | | Preexisting Conditions: Diabetes | | CDC 'Split Type': WAES0609USA02200 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Fungal infection, Pruritus genital, Vaginal infection | | Write-up: Information has been received from a licensed practical nurse concerning a 13 year old female with diabetes and no known adverse drug reactions or allergies reported. On 8/30/06, the pt was vaccinated IM with a 0.5ml dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653937/0637F). Concomitant therapy included insulin. On 9/9/06 the pt developed a yeast infection. It was reported that the pt had vaginal itching since receiving HPV It was reported that the pt underwent a vaginal swab which came back positive for yeast. The pt was being treated with Monistat. the pt was treated with the over the counter medication and was not required to follow up with the physician at this time. According to the licensed practical nurse, the physician did not feel that HPV was the cause of the yeast infection and that it was the pts mother who inquired about the event. At the time of this report, the pt had recovered from the yeast infection (date unk). No further information is available. |
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| VAERS ID: | 264740 | Vaccination Date: | 2006-09-05 | | Age: | 42.0 | Onset Date: | 2006-09-05 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | California | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Wellbutrin, Lasix | | Preexisting Conditions: Abortion, Pregnancy, Drug hypersensitivity. | | CDC 'Split Type': WAES0609USA02222 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Infection, Injection site mass, Injection site reaction, Pruritus | | Write-up: Information has been received from a 42 year old female with hypersensitivity to SOMA and a history of two pregnancies, and two unspecified abortions who on 9/5/06 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine yeast (0.5ml). Concomitant therapy included Lasix and Wellbutrin. The pt reported that on 9/5/06 she developed an injection site reaction. The pt reported that the reaction was like straph infection and described the reaction as looking like and itching like a big mosquito bite. The pt had not yet contacted her physician. At the time of this report, the pt had not yet recovered from the injection site reaction. No further information is expected. |
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| VAERS ID: | 264741 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Dakota | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA02251 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypoaesthesia, Injection site pain, Pain, Paraesthesia | | Write-up: Information has been received from a licensed practical nurse concerning a female pt who on an unspecified date was vaccinated IM with HPV rL1 6 11 16 18 VLP vaccine yeast. Subsequently the pt experienced pain, numbness, and at tingly feeling all the way down to her fingertips. The events occurred in the arm in which the pt received the vaccination. Unspecified medical attention was sought. The pt subsequently recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264742 | Vaccination Date: | 2006-09-12 | | Age: | 22.0 | Onset Date: | 2006-09-12 Days later: 0 | | Gender: | Female | Submitted: | 2007-01-05 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA02498 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 1 | IM | UN | |
| Administered by: Private Purchased by: Other | | Symptoms: Hypoaesthesia, Paraesthesia | | Write-up: Information has been received from a physician concerning a 22 year old female pt who on 9/12/06 was vaccinated IM into the upper left buttock with a dose of HPV rL1 6 11 16 18 VLP vaccine yeast, lot 653650/0702F. there was no concomitant medication. Approx one hour post vaccination the pt experienced numbness and tingling on the right side of her face. medial attention was sought. No other symptoms were noted. As of the report date, the pt was recovering. Additional information has been requested. This is in follow-up to report (s) previously submitted on 10/13/2006. Information has been received from a physician concerning a 22 year old female patient who on 12-SEP-2006 was vaccinated IM into the upper left buttock with a dose of GARDASIL lot #653650/0702F. There was no concomitant medication. Approximately one hour post vaccination the patient experienced numbness and tingling on the right side of her face. Medical attention was sought. No other symptoms were noted. As of the report date, the patient was recovering. Follow up information has been received concerning the 22 year old white female with no medical history who on the morning of 12-SEP-2006 was vaccinated IM into the upper left buttock with her second dose of GARDASIL, lot #653650/0702F. It was reported that right facial numbness developed within 1 hour after the injection. No diagnostic/laboratory tests were performed. The patient was reported to be recovered from right facial numbness. Additional information is not expected. |
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| VAERS ID: | 264743 | Vaccination Date: | 2006-09-11 | | Age: | 21.0 | Onset Date: | 2006-09-12 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-31 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: Zithromax, Wellbutrin, Klonopin, Lexapro, Nicomide, Minocycline. | | Preexisting Conditions: Syncope, Anxiety. | | CDC 'Split Type': WAES0609USA02502 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Feeling abnormal, Headache, Malaise, Mydriasis | | Write-up: Information has been received from a registered nurse concerning a 21 year old female with syncope, anxiety and no known allergies reported. On 9/11/06, the pt was vaccinated IM with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653650/0702F). Concomitant therapy included Lexapro, Wellbutrin, Klonopin, Nicomide, and Zithromax. On 9/12/06 when the pt woke up, she complained of her pupils being dilated, a headache, light headed and reported that she feels like something in not quite right. It was reported that it was unknown if the pt had eaten that day. The pt sought unspecified medical attention. At the time of this report, the pt had not recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264744 | Vaccination Date: | 2006-09-12 | | Age: | | Onset Date: | 2006-09-12 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA02785 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Nausea, Vomiting | | Write-up: Information has been received from a pharmacy intern concerning a female who on 9/12/06 the pt experienced nausea and vomiting. Unspecified medical attention was sought. At the time of this report, the outcome of the events was unk. Additional information has been requested. |
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| VAERS ID: | 264745 | Vaccination Date: | 2006-08-31 | | Age: | 16.0 | Onset Date: | 2006-09-06 Days later: 6 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maine | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Breast lump, Flu symptoms | | Diagnostic Lab Data: Urine beta human 09/06/06 positive. | | Previous Vaccinations: | | Other Medications: Zoloft | | Preexisting Conditions: Pregnancy, breast lump, flu symptoms. depression. | | CDC 'Split Type': WAES0609USA02871 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | 0 | IM | UN | |
| Administered by: Private Purchased by: Other | | Symptoms: Unintended pregnancy, Viral infection | | Write-up: Information has been received through the pregnancy registry from a nurse practitioner concerning a 15 year old female with no known drug allergies, and with depression who on 8/31/06 at 3:00pm was vaccinated IM in the right deltoid with the first dose of HPV rL1 6 11 16 18 VLP vaccine yeast (lot 653937/0637F). Illnesses at the time of vaccination included flu symptoms and a breast lump. Concomitant therapy included sertraline HCL (Zoloft). Other vaccinations given on 9/6/06 included diphtheria toxoid + pertussis acellular vaccine (unspecified) + tetanus toxoid. On 9/6/06 the pt was seen at her physician with a complaint of continued viral illness. It was reported that the pt was aware that she was pregnant but did not disclose this information to her health care provider until after vaccination. A urine pregnancy test was performed and found to be positive. The pt was advised no to receive the second dose of HPV. At the time of this report, the outcome of the viral illness and vaccine exposure during pregnancy was not known. Additional information has been requested. |
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| VAERS ID: | 264746 | Vaccination Date: | 2006-09-11 | | Age: | | Onset Date: | 2006-09-11 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA03257 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Rash maculo-papular | | Write-up: Information has been received from a physician concerning a female patient who on 11-SEP-2006 was vaccinated with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). The physician reported that within 24 hours of receiving the vaccine the patient developed a maculo papular rash all over the body. Medical attention was sought. The patient's outcome was unknown. Additional information has been requested. |
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| VAERS ID: | 264747 | Vaccination Date: | 0000-00-00 | | Age: | 20.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA03270 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a nurse practioner concerning her 20 year old daughter who on an unspecified date was vaccinated with 0.5 mL of HPV rL1 6111618 VLP vaccine (yeast). It was reported that "right after she got it", the patient developed severe arm pain (date unknown). The patient sought unspecified medical attention. At the time of this report, the patient was recovering from the event. Additional information has been requested. |
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| VAERS ID: | 264748 | Vaccination Date: | 2006-09-12 | | Age: | 20.0 | Onset Date: | 2006-09-13 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Indiana | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Body temp 09/13/06 103.6 degr | | Previous Vaccinations: | | Other Medications: MICROGESTIN FE | | Preexisting Conditions: Sulfonamide allergy | | CDC 'Split Type': WAES0609USA03694 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0641F | 0 | IM | | |
| Administered by: Private Purchased by: Private | | Symptoms: Pain, Pyrexia | | Write-up: Initial and follow up information has been received from a physician concerning a 20 year old female patient with sulfonamide allergy who on 12-SEP-2006 at 13:45 p.m. was vaccinated IM in the left deltoid with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast), lot #653650/0641. Concomitant therapy included ethinyl estradiol (+) ferrous fumarate (+) norethindrone acetate (MICROGESTIN FE). On the early morning of 13-SEP-2006 the patient developed a fever to 103.6 degrees F, and generalized body aches. Medical attention was sought. On 18-SEP-2006, the patient recovered. Additional information is not expected. |
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| VAERS ID: | 264749 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA04154 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Malaise, Syncope | | Write-up: Information has been received from a nurse practioner concerning a female patient (age not reported) who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (Lot# not provided). Subsequently, the patient fainted post vaccination. She stated that it "felt like the medicine traveled through my system at time of injection". Subsequently, the patient recovered from the syncope and abnormal feeling. The nurse reported that the patient was not disoriented, was very aware and her blood pressure (actual BP not reported) was within normal limits. The patient was offered a sugar drink (soda) after the event and recovered from the event. The nurse practitioner noted that the patient had eaten before coming in for the vaccination. Additional has been requested. |
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| VAERS ID: | 264750 | Vaccination Date: | 2006-09-18 | | Age: | 28.0 | Onset Date: | 2006-09-18 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New York | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: (therapy unspecified), LEXAPRO, FLOVENT, lorazepam, AMBIEN | | Preexisting Conditions: Concurrent conditions: epilepsy, asthma, drug hypersensitivity. | | CDC 'Split Type': WAES0609USA04248 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | UNK | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Fatigue, Headache, Nausea | | Write-up: Information has been received from a 28 year old female patient with epilepsy, asthma and an allergy to carbamazepine (TEGRETOL) who on 18-SEP-2006 was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included escitalopram oxalate (LEXAPRO), lorazepam, "lomectol," zolpidem tartrate (AMBIEN), and fluticasone propionate (FLOVENT). The patient stated that since her vaccination she has been experiencing dizzy, tired, has headaches and felt nauseous. No medical attention was sought. As of the report date the patient has not recovered. Additional information has been requested. |
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| VAERS ID: | 264751 | Vaccination Date: | 2006-08-01 | | Age: | 19.0 | Onset Date: | 2006-08-01 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Sulfonamide allergy | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: EFFEXOR | | Preexisting Conditions: | | CDC 'Split Type': WAES0609USA04418 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | UNK | 0 | UN | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Pyrexia | | Write-up: Information has been received from a licensed practical nurse concerning a female patient with sulfonamide allergy who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced a fever for four days. Unspecified medical attention was sought. No further details were provided. Additional information has been requested. This is a follow-up to report (s). Information has been received from a physician concerning his 19 year old daughter with a sulfonamide allergy and no other pertinent medical history reported. In August 2006, the patient was vaccinated with the first dose of GARDASIL by another health care professional. Concomitant therapy included EFFEXOR. In approximately August 2006, "about 4 days after being vaccinated", the patient developed a primary herpetic gingivostomatitis on her lips. The patient sought unspecified medical attention. All symptoms had resolved. At the time of this report. The patient had recovered from the event (date unknown). Additional information has been requested. |
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| VAERS ID: | 264753 | Vaccination Date: | 2006-09-11 | | Age: | 18.0 | Onset Date: | 2006-09-12 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA04898 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653735/0688F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pyrexia, Rash vesicular | | Write-up: Information has been received from a physician concerning a 17 year old female with no history of varicella virus vaccine live vaccination and an unknown history of varicella, who on 11-SEP-2006 was vaccinated intramuscularly with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). There was no concomitant medication. The physician reported that on 12-SEP-2006 "the next day, the patient developed a low grade fever and a vesicular rash on her neck and shoulders of about 15-20 lesions." The patient was treated with acetaminophen (TYLENOL). All of her symptoms resolved within 3-4 days (approximately 15-SEP-2006). Additional information has been requested. |
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| VAERS ID: | 264754 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA04922 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264755 | Vaccination Date: | 2006-09-20 | | Age: | 25.0 | Onset Date: | 2006-09-21 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: LEXAPRO, RITALIN | | Preexisting Conditions: Concurrent conditions: connective tissue disorder, thrombocytopenia, depression, drug hypersensitivity | | CDC 'Split Type': WAES0609USA05006 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pyrexia | | Write-up: Information has been received from a medical assistant concerning a 25 year old female with connective tissue disorder, thrombocytopenia, depression and allergy to ZITHROMAX who on 20-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) IM in the deltoid described as "pre-filled syringe one time." Concomitant therapy included escitalopram oxalate (LEXAPRO) and methylphenidate HCl (RITALIN). On 21-SEP-2006 the patient experienced fever of 100 degrees F. The patient sought unspecified medical attention. The patient's fever of 100 degrees F. persisted. Additional information has been requested. |
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| VAERS ID: | 264756 | Vaccination Date: | 2006-09-18 | | Age: | 23.0 | Onset Date: | 2006-09-18 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA05009 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site reaction | | Write-up: Information has been received from a nurse practitioner concerning a female who on 18-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced injection site reaction. The patient sought unspecified medical attention. Injection site reaction persists. Additional information has been requested. |
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| VAERS ID: | 264757 | Vaccination Date: | 2006-09-01 | | Age: | 25.0 | Onset Date: | 2006-09-08 Days later: 7 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Missouri | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: hormonal contraception | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA05017 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653937/0637F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site rash | | Write-up: Information has been received from a physician and a registered nurse concerning a 25 year old female who on 01-SEP-2006 was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 08-SEP-2006, one week after vaccination, the patient developed "small bumps under her skin" at the injection site. The patient sought unspecified medical attention. Subsequently, the patient fully recovered. |
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| VAERS ID: | 264758 | Vaccination Date: | 2006-09-01 | | Age: | 18.0 | Onset Date: | 2006-09-08 Days later: 7 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Carolina | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA05491 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | IM | UN | |
| Administered by: Other Purchased by: Private | | Symptoms: Rash pruritic, Rash vesicular | | Write-up: Information has been received from a pharmacist concerning a female patient (age not reported) a physician mentioned who was vaccinated on an unspecified date with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient developed a poison ivy-like rash on her shoulder behind the area where she was administered the vaccine. The rash was reported to be itchy, vesicular and the size of a grapefruit. The patient sought unspecified medical attention. At the time of this report the patient had not recovered. Additional information has been requested. |
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| VAERS ID: | 264759 | Vaccination Date: | 2006-09-07 | | Age: | 20.0 | Onset Date: | 2006-09-07 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Florida | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA05508 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | | |
| Administered by: Private Purchased by: Other | | Symptoms: Oedema peripheral | | Write-up: Information has been received from a physician concerning a 21 year old female who on an unknown date was vaccinated intramuscularly with the first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # not provided). Subsequently, the patient developed "swelling feet" for an unspecified amount of time after receiving the injection. At the time of this report the patient was recovering. Additional information has been requested. |
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| VAERS ID: | 264760 | Vaccination Date: | 0000-00-00 | | Age: | 14.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Carolina | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA05516 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site inflammation, Injection site pain | | Write-up: Information has been received from a physician concerning a 14 year old female who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot # not provided). Subsequently, the patient experienced burning and pain at the injection site. Unspecified medical attention was sought. It was unknown at the time of the report if the patient had recovered. Additional information has been requested. |
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| VAERS ID: | 264761 | Vaccination Date: | 2006-08-15 | | Age: | 18.0 | Onset Date: | 2006-08-15 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: TUBERSOL, Aventis Pasteur, C2250AB | | Preexisting Conditions: None | | CDC 'Split Type': WAES0609USA05927 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0641F | 0 | IM | RA | | TDAP | SANOFI PASTEUR | C2151AC | 0 | IM | LA | |
| Administered by: Private Purchased by: Military | | Symptoms: | | Write-up: Information has been received from a physician concerning his "around 18" year old daughter who was vaccinated IM with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included a dose of diphtheria toxoid (+) pertussis acellular 3-component vaccine (+) tetanus toxoid (BOOSTRIX). Subsequently, the patient experienced numbness in her arms and lower extremities. Unspecified medical attention was sought. On an unspecified date, the patient recovered. No product quality complaint was involved. Additional information has been requested. 01/05/2007 Information has been received from a physician and health professional concerning an 18 year old female student with no medical history or allergies, who on 15-AUG-2006 at 09:00 was vaccinated IM into the right arm with a 0.5 ml first dose of GARDASIL (lot# 653650/0641F). Concomitant therapy included a first IM dose into the left arm of ADACEL (batch # C2151AC) and TUBERSOL (batch#C2250AB). On 15-AUG-2006 at 12:00, the patient experienced numbness in her arms and lower extremities. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. On 21-AUG-2006, the patient recovered completely. Additional information is not expected. |
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| VAERS ID: | 264762 | Vaccination Date: | 2006-09-25 | | Age: | 26.0 | Onset Date: | 2006-09-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: Concurrent conditions: penicillin allergy | | CDC 'Split Type': WAES0609USA05955 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Urticaria | | Write-up: Information has been received from a physician concerning a 26 year old female with a penicillin allergy who on 25-SEP-2006 was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Immediately post-vaccination, the patient experienced hives. The patient was treated with oral diphenhydramine hydrochloride (BENADRYL) and symptoms lessened. No diagnostic studies were performed. At the time of this report, the patient was recovering. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264763 | Vaccination Date: | 2006-09-22 | | Age: | 17.0 | Onset Date: | 2006-09-22 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Indiana | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07045 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site swelling, Lymphadenopathy, Pyrexia | | Write-up: Information has been received from a physician concerning a 17 year old female patient who on 22-SEP-2006 was vaccinated IM with a first 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). There was no concomitant medication. On 22-SEP-2006 the patient developed swollen lymph nodes in the neck and groin, swelling at injection site and low grade fever. The patient sought unspecified medical attention. It was reported that the patient was recovering. Additional information has been requested. |
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| VAERS ID: | 264765 | Vaccination Date: | 0000-00-00 | | Age: | 14.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Wyoming | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07284 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653650/0696F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a registered nurse concerning a female between the ages of 14 to 21 years old who was vaccinated IM into the deltoid region with a first 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced extreme pain during injection. No medical attention was sought. About 15 to 20 minutes after injection, the patient was improving. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264766 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07368 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264767 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07369 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264768 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07370 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264769 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07371 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264770 | Vaccination Date: | 0000-00-00 | | Age: | 15.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Maryland | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07372 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a certified medical assistant concerning a female patient between the age of 15 to 18 who was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient complained of stinging. It was noted that the stinging was only for a moment and resolved quickly. The reporter felt that the stinging could be from the vaccine being cold. No other problems were noted with the administration. Unspecified medical attention was sought. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264771 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA07427 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain | | Write-up: Information has been received from a physician's office concerning a female patient was was vaccinated IM with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). The reporter indicated that using the prefilled syringe was "painful and startling" to the patient. Her outcome was not reported. A product quality complaint was not involved. Additional information has been requested. |
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| VAERS ID: | 264772 | Vaccination Date: | 2006-09-27 | | Age: | 27.0 | Onset Date: | 2006-09-28 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Hormonal contraceptives | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA08050 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Erythema, Oedema peripheral, Pruritus | | Write-up: Information has been received from a 27 year old female with no other pertinent medical history and no known allergies or adverse drug reactions reported. On 27-SEP-2006, the patient was vaccinated with 0.5 mL of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included unspecified hormonal contraceptives (reported as "birth control"). On 28-SEP-2006, the patient developed red, itchy and swollen hands and feet. The patient sought unspecified medical attention. At the time of this report the patient was recovering from the events. Additional information has been requested. |
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| VAERS ID: | 264773 | Vaccination Date: | 2006-09-25 | | Age: | 20.0 | Onset Date: | 2006-09-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Pennsylvania | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': WAES0609USA08058 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site pain, Nausea, Pain | | Write-up: Information has been received from the mother of a female patient in her "early 20's" with no relevant medical history who on 25-SEP-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (0.5 mL). There was no concomitant medication. On 25-SEP-2006, the patient experienced "a lot of pain and nausea." The pain was described as a stinging feeling when the medication was being injected. The patient subsequently recovered from the pain and nausea one hour after vaccination. Medical attention was not sought. Additional information has been requested. |
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| VAERS ID: | 264774 | Vaccination Date: | 2006-09-26 | | Age: | 23.0 | Onset Date: | 2006-09-26 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New York | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: Concurrent conditions: cervical dysplasia, colposcopy | | CDC 'Split Type': WAES0609USA08128 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Dizziness, Medication error, Pain | | Write-up: Information has been received from a nurse practitioner concerning a 23 year old female with mild cervical dysplasia with colposcopy and no known allergies or adverse drug reactions reported. On 26-SEP-2006, the patient was vaccinated with the first dose of 0.5 mL of HPV rL1 6 11 16 18 VLP vaccine (yeast). There was no concomitant medication reported. It was reported that the pre-filled syringe had been stored at 34F. On 26-SEP-2006 the patient developed severe pain during administration with lightheadedness and dizziness. The patient was laid on the exam table and given ibuprofen (MOTRIN) for pain. The patient sought unspecified medical attention. At the time of this report, the patient had recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264775 | Vaccination Date: | 0000-00-00 | | Age: | 25.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Colorado | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0609USA08561 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Medication error, Myalgia | | Write-up: Information has been received from a registered nurse concerning a 25 year old female who in 2006 (date not reported) was vaccinated with a 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). The nurse reported having "the syringe jam and could not administer the vaccine." The vaccine was given using a second syringe. The nurse also reported that the patient experienced "muscle pain in her arm, the arm of the jammed syringe." At the time of this report, the patient had not recovered. Additional information has been requested. |
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| VAERS ID: | 264776 | Vaccination Date: | 2006-09-01 | | Age: | 18.0 | Onset Date: | 2006-09-01 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Missouri | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Body temp, 09/??/2006, 102 degrees F | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00329 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Chills, Pyrexia | | Write-up: Information has been received from a physician concerning an 18 year old female patient who in September 2006 was vaccinated IM with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently in September 2006 the patient developed 102 degree temperature and chills. Medical attention was sought. The patient was recovering. Additional information has been requested. |
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| VAERS ID: | 264777 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Texas | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00388 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from an LPN concerning a female patient who was vaccinated IM with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced pain in her arm in excess of 5 days. There was no swelling or rash, only the pain. Medical attention was sought. The pain was reported to have improved on therapy. It was unknown whether this was an injection site reaction. Additional information has been requested. |
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| VAERS ID: | 264778 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Dakota | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00698 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypoaesthesia, Injection site pain, Paraesthesia | | Write-up: Information has been received from a licensed practical nurse concerning a female patient who on an unspecified date was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain, numbness, and a tingly feeling all the way down to her fingertips. The events occurred in the arm in which the patient received the vaccination. Unspecified medical attention was sought. The patient subsequently recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264779 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Dakota | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA000699 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypoaesthesia, Pain, Paraesthesia | | Write-up: Information has been received from a licensed practical nurse concerning a female patient who on an unspecified date was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain, numbness and a tingly feeling all the way down to her fingertips. The events occurred in the arm in which the patient received the vaccination. Unspecified medical attention was sought. The patient subsequently recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264780 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Dakota | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00700 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypoaesthesia, Pain, Paraesthesia | | Write-up: Information has been received from a licensed practical nurse concerning a female patient who on an unspecified date was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain, numbness, and a tingly feeling all the way down to her fingertips. The events occurred in the arm in which the patient received the vaccination. Unspecified medical attention was sought. The patient subsequently recovered from the events. Additional information has been requested. |
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| VAERS ID: | 264781 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | North Dakota | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00701 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Hypoaesthesia, Pain, Paraesthesia | | Write-up: Information has been received from a licensed practical nurse concerning a female patient who on an unspecified date was vaccinated intramuscularly with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently the patient experienced pain, numbness, and a tingly feeling all the way down to her fingertips. The events occurred in the arm in which the patient received the vaccination. Unspecified medical attention was sought. The patient subsequently recovered from the events. Additional information has been sought. |
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| VAERS ID: | 264782 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA00860 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning a female patient "between the ages of 11 and 16 years old" who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Within 1 to 2 days after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast), the patient developed a fever and headache (date unknown). At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 264783 | Vaccination Date: | 2006-09-19 | | Age: | 11.0 | Onset Date: | 2006-09-19 Days later: 0 | | Gender: | Female | Submitted: | 2007-01-05 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: body temp 09/19/06 101 - | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: None | | CDC 'Split Type': WAES0610USA01164 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | UN | | TDAP | SANOFI PASTEUR | C2559 | 0 | UN | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning an 11 year old female patient who on an unspecified date was vaccinated IM with her first dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Within one to two days after administration, the patient developed headache and fever. No medical attention was sought. Her outcome was not reported. Additional information has been requested. This is in follow-up to report (s) previously submitted on 10/13/2006. Information has been received from a physician concerning a 11 year old female patient who on an unspecified date was vaccinated IM with her first dose of GARDASIL. Within one to two days after administration, the patient developed headache and fever. No medical attention was sought. Her outcome was not reported. Follow up information has been received regarding the 11 year old white female with no medical history who at 2:30 p.m. on 19-SEP-2006 was vaccinated in the right arm with her first dose of GARDASIL, lot #653735/0688F. She received her first dose of ADACEL in the left arm at the same time. At 7:00 p.m. on the same day, she developed a headache. She woke up during the night with severe headache. Fever was approximately 101-102. On the afternoon of 20-SEP-2006 she was better and able to attend school. It was reported that she recovered from headache and fever on the afternoon of 20-SEP-2006. Additional information is not expected. |
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| VAERS ID: | 264784 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA01349 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning a female patient "between the ages of 11 and 16 years old" who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Within 1 to 2 days after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast), the patient developed a fever and headache (date unknown). At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 264785 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA01350 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning a female patient "between the ages of 11 and 16 years old" who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Within 1 to 2 days after receiving HPV rL1 6 11 16 18 VLP vaccine (yeast), the patient developed a fever and headache (date unknown). At the time of this report, the outcome of the events were unknown. Additional information has been requested. |
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| VAERS ID: | 264786 | Vaccination Date: | 2006-09-01 | | Age: | 25.0 | Onset Date: | 2006-09-08 Days later: 7 | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Missouri | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: Hormonal contraceptives | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03087 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653937/0637F | | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Injection site reaction | | Write-up: Information has been received from a physician and a registered nurse concerning a 25 year old female who on 01-SEP-2006 was vaccinated IM with a 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Concomitant therapy included hormonal contraceptives (unspecified). On approximately 08-SEP-2006, one week after vaccination, the patient developed "small bumps under her skin" at the injection site. The patient sought unspecified medical attention. Subsequently, the patient fully recovered. Additional information has been requested. |
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| VAERS ID: | 264787 | Vaccination Date: | 0000-00-00 | | Age: | 13.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03614 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning a 13 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. |
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| VAERS ID: | 264788 | Vaccination Date: | 2006-09-27 | | Age: | 16.0 | Onset Date: | 2006-09-28 Days later: 1 | | Gender: | Female | Submitted: | 2007-05-21 | | State: | New Jersey | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: body temp, 09/28/06, 100 | | Previous Vaccinations: | | Other Medications: Unknown | | Preexisting Conditions: None | | CDC 'Split Type': WAES0610USA03615 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | UN | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Headache, Pyrexia | | Write-up: Information has been received from a physician concerning a 16 year old female patient who on an unspecified date was vaccinated with a dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient developed headache and fever. Her outcome was not reported. Additional information has been requested. Follow up information has been received concerning the patient with no medical history who on 27-SEP-2006 at 2:00 p.m. received her first dose of GARDASIL, lot #553735/0688F, in the right arm. On 28-SEP-2006 at 8:00 a.m. the patient developed headache and fever (approximeately 100 oral temperature). The patient complained of headache pain behind eyes that was relieved by ADVIL. It was reported that on 29-SEP-2006 she recovered. This is an consolidation of two reports concerning the same patient. Additional information is not expected. WAES #0610USA01350 was previously submitted on 13-OCT-2006. |
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| VAERS ID: | 264789 | Vaccination Date: | 0000-00-00 | | Age: | 14.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Wyoming | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03622 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653650/0696F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a registered nurse concerning a female between the ages of 14 to 21 years old who was vaccinated IM into the deltoid region with a first 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced extreme pain during injection. The patient had to lie down for a short time period until the pain subsided. No medical attention was sought. About 15 to 20 minutes after injection, the patient was improving. No product quality complaint was involved. Additional information has been requested. |
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| VAERS ID: | 264790 | Vaccination Date: | 0000-00-00 | | Age: | 14.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Wyoming | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03624 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 653650/0696F | 0 | IM | | |
| Administered by: Other Purchased by: Other | | Symptoms: Pain | | Write-up: Information has been received from a registered nurse concerning a female between the ages of 14 to 21 years old who was vaccinated IM into the deltoid region with a first 0.5 mL dose of HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient experienced extreme pain during injection. No medical attention was sought. About 15 to 20 minutes after injection, the patient was improving. No product quality complaint was involved. Additional information has been requested. |
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|
| VAERS ID: | 264791 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: UNK | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03816 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Malaise, Syncope | | Write-up: Information has been received from a nurse practitioner concerning a female patient (age not reported) who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient fainted post vaccination. She stated that it "felt like the medicine traveled through my system at time of injection." Subsequently, the patient recovered from the syncope and abnormal feeling. The nurse reported that the patient was not disoriented, was very aware and her blood pressure (actual BP not reported) was within normal limits. The patient was offered a sugar drink (soda) after the event and recovered from the event. The nurse practitioner noted that the patient had eaten before coming in for the vaccination. Additional information has been requested. |
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| VAERS ID: | 264792 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03817 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a nurse practitioner concerning a female patient (age not reported) who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient fainted post vaccination. Subsequently, the patient recovered from the syncope. The nurse reported that the patient was not disoriented, was very aware and her blood pressure (actual BP not reported) was within normal limits. The patient was offered a sugar drink (soda) after the event and recovered from the event. The nurse practitioner noted that the patient had eaten before coming in for the vaccination. Additional information has been requested. |
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| VAERS ID: | 264793 | Vaccination Date: | 0000-00-00 | | Age: | | Onset Date: | 0000-00-00 Days later: | | Gender: | Female | Submitted: | 2006-10-13 | | State: | Unknown | Entered: | 2006-10-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: UNK | | CDC 'Split Type': WAES0610USA03818 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | | |
| Administered by: Other Purchased by: Other | | Symptoms: Syncope | | Write-up: Information has been received from a nurse practitioner concerning a female patient (age not reported) who on an unspecified date was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast). Subsequently, the patient fainted post vaccination. Subsequently, the patient recovered from the syncope. The nurse reported that the patient was not disoriented, was very aware and her blood pressure (actual BP not reported) was within normal limits. The patient was offered a sugar drink (soda) after the event and recovered from the event. The nurse practitioner noted that the patient had eaten before coming in for the vaccination. Additional information has been requested. |
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| VAERS ID: | 264950 | Vaccination Date: | 2006-09-19 | | Age: | 57.0 | Onset Date: | 2006-10-03 Days later: 14 | | Gender: | Female | Submitted: | 2006-10-16 | | State: | Wisconsin | Entered: | 2006-10-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: Valve Proplase in distant past, neg heart cath 2 yrs ago. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0039F | 0 | IM | LA | | MMR | MERCK & CO. INC. | 0296R | | SC | RA | |
| Administered by: Other Purchased by: Other | | Symptoms: Chest pain, Hypoaesthesia, Lymphadenopathy | | Write-up: 09/19/2006 MMR and HBV adm 1, 10/03/2006 swollen glands, numbness and tingling of arm and legs bilat. Pt called hotline and states she was told this was from the MMR. 10/15/06 chest pain. Pt wonders if this is related to immunizations. |
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| VAERS ID: | 264959 | Vaccination Date: | 2006-10-16 | | Age: | 13.0 | Onset Date: | 2006-10-16 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-19 | | State: | Connecticut | Entered: | 2006-10-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: Scheduled for cardiac and Neuro follow up. LABS: IgG was only positive for Lyme dx which was considered negative. | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HEPA | MERCK & CO. INC. | 0741F | 0 | IM | RA | | HPV4 | MERCK & CO. INC. | 0955F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Bradycardia, Coma, Heart rate irregular, Musculoskeletal stiffness, Pallor, Syncope, Urinary incontinence | | Write-up: Administred VAQTA, then GARDASIL, immediately after GARDASIL child became unresponsive, stiff, pale about 30 sex. Child lost bladder control, pulse 46-55 after event, child alert and aware after events. 11/27/06 Received medical records from provider/reporter which reveal patient had LOC, tonic/clonic movements & loss of bladder control after received 2nd GARDASIL vax. HR was 46-55. This was the 3rd episode of LOC within a year (1st after tetanus shot, 2nd after finding a tick & 3rd after 2nd dose of GARDASIL). PCP recommended cardiac & neuro w/u. Received cardiac consultation which revealed final dx: probable fainting. Holter monitor was WNL. Awaiting neuro consult. |
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| VAERS ID: | 264992 | Vaccination Date: | 2006-10-16 | | Age: | 15.0 | Onset Date: | 2006-10-18 Days later: 2 | | Gender: | Female | Submitted: | 2006-10-19 | | State: | California | Entered: | 2006-10-19 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0637F | | | RA | | TDAP | SANOFI PASTEUR | C2572AA | | | LA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Blister, Face oedema | | Write-up: Received Tdap and HPV vaccine on 10/16/2006 noticed some blisters at the corner of mouth and swelling of lower lip on the evening of 10/18/2006 and facial swelling around eyes on 10/19/06. No fever, headache, dizziness or any GI symptoms. |
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| VAERS ID: | 265013 | Vaccination Date: | 2006-10-09 | | Age: | 23.0 | Onset Date: | 2006-10-16 Days later: 7 | | Gender: | Female | Submitted: | 2006-10-17 | | State: | Kentucky | Entered: | 2006-10-20 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Lexapro, Effexor, Yasmin, HCTZ, Elmiron, Parida Plus, Claritin. | | Preexisting Conditions: Sulfa Allergy, Hypertension, Intestinal cystitis. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Headache, Injection site reaction, Pruritus, Thermal burn | | Write-up: Localized reaction at injection site right del itching and burning beginning 7 day post injection, also headache. Txd symptoms with Benadryl, Tylenol, Hydrocortisone cream. |
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| VAERS ID: | 265107 | Vaccination Date: | 2006-10-19 | | Age: | 20.0 | Onset Date: | 2006-10-19 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-19 | | State: | Unknown | Entered: | 2006-10-23 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0955F | | IM | UN | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Asthenia, Dizziness, Hyperhidrosis | | Write-up: After receiving Gardasil vaccine #1 pt immediately became lightheaded, weak and sweaty. SX lasted approx 5 minutes. (OMIC). Per 60 day follow up: Patient received GARDASIL # 2 on 2/20/07, uneventful. |
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| VAERS ID: | 265305 | Vaccination Date: | 2006-10-16 | | Age: | 21.0 | Onset Date: | 2006-10-16 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-24 | | State: | Florida | Entered: | 2006-10-24 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None. | | Diagnostic Lab Data: N/A | | Previous Vaccinations: | | Other Medications: Ortho-tricyclene Low | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | Unknown | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Difficulty in walking, Muscle rigidity, Syncope | | Write-up: According to my daughter, the following happened: 1. Shot was given between 1100-1115 am 2. Proceed to wait a few minutes with doctor in room and then went to check out 3. Between 1120-1125 am...she passed out in doctors office. 4. Day 2-4: tightness in muscles especially around lower legs. Also tigtness in arms, but not as bad as legs. 5. Hard time walking after first waking up in morning and gradually loosens up after she starts moving around. 6. I suggested to her to take a Tylenol to help with muscle tightness and to massage calves prior to getting out of bed to help loosen them up. |
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| VAERS ID: | 265338 | Vaccination Date: | 2006-10-13 | | Age: | 1.0 | Onset Date: | 0000-00-00 Days later: | | Gender: | Male | Submitted: | 2006-10-17 | | State: | Michigan | Entered: | 2006-10-25 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | SANOFI PASTEUR | V2175HA | 0 | IM | UN | | HEPA | GLAXOSMITHKLINE BIOLOGICALS | AHAVB099CB | 0 | IM | UN | | HIBV | MERCK & CO. INC. | 0212R | 3 | IM | UN | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | UN | | PNC | WYETH PHARMACEUTICALS, INC | B22930D | 3 | IM | LL | |
| Administered by: Private Purchased by: Public | | Symptoms: Wrong drug administered | | Write-up: None Stated |
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| VAERS ID: | 265357 | Vaccination Date: | 2006-10-13 | | Age: | 18.0 | Onset Date: | 2006-10-20 Days later: 7 | | Gender: | Female | Submitted: | 2006-10-25 | | State: | Kentucky | Entered: | 2006-10-25 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: none | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0660F | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Injection site erythema, Injection site pain, Injection site swelling | | Write-up: Approximately 7 days after HPV IM, L deltoid became very sore, painful to abduct. Nosig soreness at 24 hours after IM. On exam is tender deep in muscle and is enlarged. No surface redness. No induration. |
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| VAERS ID: | 265372 | Vaccination Date: | 2006-10-06 | | Age: | 24.0 | Onset Date: | 2006-10-06 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-23 | | State: | California | Entered: | 2006-10-26 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? Yes |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0610USA09738 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | IM | UN | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Eye swelling, Pruritus, Vision blurred | | Write-up: Information has been received from a physician concerning a 24 year old female pt with no known allergies or reportable medical history who on 10/6/06 was vaccinated IM with a 0.5ml dose of HPV. Several hours later, on 10/6/06 the pt called the office with complaints of swollen puffy eyes, some itching but no rash and blurry vision. The pt was seen in the office that evening on 10/6/06 and was given a dose of Benadryl and was sent home. The pt took a nap for the blurry vision and upon awakening the next morning the pt fully recovered. Blurry vision was considered to be disabling according to the physician since the pt was unable to perform her normal task. Additional information has been requested. |
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| VAERS ID: | 265384 | Vaccination Date: | 2006-10-23 | | Age: | 22.0 | Onset Date: | 2006-10-23 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-23 | | State: | Unknown | Entered: | 2006-10-26 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0966P | | IM | | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Asthenia, Dizziness, Hyperhidrosis, Syncope vasovagal | | Write-up: Few minutes after receiving Gardasil vaccine patient had vaso vagal type reaction, weak, dizzy, hot, sweaty. Felt like she was going to faint. |
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| VAERS ID: | 265435 | Vaccination Date: | 2006-10-17 | | Age: | 22.0 | Onset Date: | 2006-10-17 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-26 | | State: | Pennsylvania | Entered: | 2006-10-26 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0641F | 0 | | RA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Acne | | Write-up: Papules used BENADRYL and cortisone. Pt experienced severe case of hives over torso and legs ankle and feet. Hives lasted 4 days. Pt was given BENADRYL. |
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| VAERS ID: | 265676 | Vaccination Date: | 2006-10-17 | | Age: | 19.0 | Onset Date: | 2006-10-22 Days later: 5 | | Gender: | Female | Submitted: | 2006-10-26 | | State: | North Carolina | Entered: | 2006-10-31 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: Thyroid, Potassium levels done. Given flu vaccine 10/27/06 | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0955F | 0 | IM | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Anxiety, Cough, Hypersensitivity, Hypoaesthesia, Psychomotor hyperactivity, Pyrexia | | Write-up: Fever, cough, numb, and tingling all over, acted hyperactive loopy, taking OTC cold remedies, MD suggested Claritin and nasal spray for allergies, may need anti anxiety and anti depressant for ADHD, anxiety. |
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| VAERS ID: | 265756 | Vaccination Date: | 2006-08-01 | | Age: | 21.0 | Onset Date: | 2006-08-03 Days later: 2 | | Gender: | Female | Submitted: | 2006-11-01 | | State: | Missouri | Entered: | 2006-11-01 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: none | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Doxycycline,Zoloft,Yasmin | | Preexisting Conditions: Depression & Anxiety, Migraine Headaches, Acne, Exzema, Seasonal Allergies. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Hypoaesthesia | | Write-up: Patient complained of Left arm numbness after receiving injection. Lasted less than 48 hours. |
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| VAERS ID: | 265801 | Vaccination Date: | 2006-10-25 | | Age: | 16.0 | Onset Date: | 2006-10-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-10-26 | | State: | Washington | Entered: | 2006-11-01 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 1 | | LA | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Vomiting | | Write-up: Patient reports she vomited 1 time approximately 4 hours following injection of Gardasil. Patient's mother reports that the patient vomited following the first injection in series. |
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| VAERS ID: | 265808 | Vaccination Date: | 2006-10-06 | | Age: | 21.0 | Onset Date: | 2006-10-07 Days later: 1 | | Gender: | Female | Submitted: | 2006-10-30 | | State: | Maryland | Entered: | 2006-11-01 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Estrostep | | Preexisting Conditions: allergic to Penicillin. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0800F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Chills, Nausea, Pyrexia, Vomiting | | Write-up: Nausea and vomiting, fever 99 degrees F- 100 degrees F, chills for 3 days. |
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| VAERS ID: | 265839 | Vaccination Date: | 2006-09-20 | | Age: | 17.0 | Onset Date: | 2006-10-09 Days later: 19 | | Gender: | Female | Submitted: | 2006-10-30 | | State: | Ohio | Entered: | 2006-11-02 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? Yes, 2 days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: 12/12/06-records received-EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibila nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre | | Previous Vaccinations: | | Other Medications: UNK | | Preexisting Conditions: | | CDC 'Split Type': WAES0610USA11542 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0954F | 0 | UN | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Asthenia, Back pain, Electromyogram abnormal, Hypoaesthesia, Musculoskeletal pain, Neck pain, Paraesthesia | | Write-up: Information has been received from a physician concerning a 16 year old female who on an unspecified date was vaccinated with the first dose of HPV vaccine. subsequently the pt developed lower extremity weakness and was hospitalized for two days with Guillain Barre. The pt received treatment with gamma globulin during her hospitalization. At the time of this report, the pt was back to school and was 99% recovered having only some area of numbness to her lower extremities. The physician did not believe that the pt was on any other medications at the time and had no further details to provide. Additional information has been requested. Mild Guillane Barre Syndrome. EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibial nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre Syndrome. 12/12/06-records received from facility. DX Mild Guillain Barre Syndrome. 12/28/06-DC Summary received DC DX: Mild Guillain Barre Syndrome. 1.5 week duration of tingling below kness and above ankle bilaterally. Pain with walking. Office note for DO 12/28/06 from pediatric neurologist:continues to have tingling from elbow to hands, improving. On Neurontin 100 mg tabs 1 three times per day. Has pain across shoulders and neck also lower back. Will order labs. |
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| VAERS ID: | 265955 | Vaccination Date: | 2006-10-21 | | Age: | 13.0 | Onset Date: | 2006-10-21 Days later: 0 | | Gender: | Female | Submitted: | 0000-00-00 | | State: | California | Entered: | 2006-11-03 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | | | UN | | VARCEL | MERCK & CO. INC. | | 1 | SC | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Hypoaesthesia, Injection site pain, Syncope | | Write-up: Per pt arm where Gardasil was administered felt painful then numb and then pt fainted for a few seconds. |
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| VAERS ID: | 266325 | Vaccination Date: | 2006-08-30 | | Age: | 21.0 | Onset Date: | 2006-08-30 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-01 | | State: | West Virginia | Entered: | 2006-11-08 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0696F | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Pain | | Write-up: Complaints of pain in right arm initially after 1st Gardasil injection. States right arm hurt for 1 month after shot was given. |
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| VAERS ID: | 266371 | Vaccination Date: | 2006-10-03 | | Age: | 15.0 | Onset Date: | 2006-10-06 Days later: 3 | | Gender: | Female | Submitted: | 2006-11-06 | | State: | California | Entered: | 2006-11-09 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? Yes |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Ortho Tri Cyclen LO | | Preexisting Conditions: Hypersensitivity. | | CDC 'Split Type': WAES0610USA14679 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Pruritus, Urticaria | | Write-up: Information has been received from a physician and the mother of a 15 year old female with a history of hypersensitivity reactions to allergens. On 10/3/06, the pt was vaccinated IM with the first dose of 0.5ml of HPV vaccine (lot 653650/0702F. Concomitant therapy included Ortho Tri Cyclen LO started on 10/6/06. On 10/06/06, the pt developed widespread itching and hives of both upper and lower extremities. The pt did not experience respiratory symptoms. The pt was self treated with Benadryl with only mild improvement. A nurse in the local ER was consultated by phone but the pt did not require hospitalization. The symptoms resolved after one week and the pt had not experienced further problems. On 10/13/06 the pt had recovered from the event. The physician considered the event to be serious as disabling. Additional information has been requested. |
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| VAERS ID: | 266497 | Vaccination Date: | 2006-10-30 | | Age: | 17.0 | Onset Date: | 2006-10-30 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-10 | | State: | Indiana | Entered: | 2006-11-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Advil, Benadryl, Tylenol | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Disorientation, Dizziness, Dyspnoea, Nausea, Syncope | | Write-up: Patient fainted in waiting area less than five minutes after receiving Gardasil injection. Patient disoriented and c/o difficulty breathing when roused. C/O nausea, dizziness. Sent to ER & diagnosed as vasovagal syncope. Patient c/o sores in genital area 3 days post vaccination. Upon visit to doctor, diagnosed with Condyloma. |
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| VAERS ID: | 266541 | Vaccination Date: | 2006-09-13 | | Age: | 14.0 | Onset Date: | 2006-09-14 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-10 | | State: | Kentucky | Entered: | 2006-11-10 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702P | 0 | | RA | |
| Administered by: Private Purchased by: Private | | Symptoms: Angioneurotic oedema, Face oedema | | Write-up: Angioedema lips for one month by history from pt. |
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| VAERS ID: | 266568 | Vaccination Date: | 2006-10-25 | | Age: | 12.0 | Onset Date: | 2006-10-25 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-01 | | State: | West Virginia | Entered: | 2006-11-13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0955F | 1 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Irritability, Rash | | Write-up: Fussy body rash X 24 hours following vaccination. Cleared spontaneously. |
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| VAERS ID: | 266581 | Vaccination Date: | 2006-10-13 | | Age: | 19.0 | Onset Date: | 2006-10-13 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-08 | | State: | Virginia | Entered: | 2006-11-13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: Skin prick tested for allergies. | | Previous Vaccinations: Fever~DTP (unknown mfr)~1~1~In Patient | | Other Medications: Allegra, Nasolcrom, Acne meds, Bactrim | | Preexisting Conditions: Acne, allergies to raw peaches, carrot, potatoes, kiwi, apples, cherries. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | AVENTIS PASTEUR | U2165CA | 2 | IM | RA | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Blood pressure decreased, Bradycardia, Heart rate irregular | | Write-up: Vasovagal RXN. Pt HR decreased to 50 and BP decreased. |
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| VAERS ID: | 266592 | Vaccination Date: | 2006-10-31 | | Age: | 11.0 | Onset Date: | 2006-11-01 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-06 | | State: | Pennsylvania | Entered: | 2006-11-13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: None | | Previous Vaccinations: | | Other Medications: None | | Preexisting Conditions: None | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | AVENTIS PASTEUR | U2199AA | 4 | IM | RA | | HPV4 | MERCK & CO. INC. | 0955F | 0 | IM | RA | | TDAP | GLAXOSMITHKLINE BIOLOGICALS | AC52B011CA | 5 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Erythema, Rash, Rash papular | | Write-up: Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet. |
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| VAERS ID: | 266639 | Vaccination Date: | 2006-11-08 | | Age: | 16.0 | Onset Date: | 2006-11-08 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-13 | | State: | Maine | Entered: | 2006-11-13 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: CONCERTA 54mg | | Preexisting Conditions: Attention-deficit Hyperactivity disorder | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | | RA | | MNQ | AVENTIS PASTEUR | U1808AA | 0 | | LA | |
| Administered by: Private Purchased by: Other | | Symptoms: Erythema, Swelling, Tenderness | | Write-up: 10.4 cm X 7.0 cm area of redness. Swelling and tenderness. Complain of burning at site left deltoid. |
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| VAERS ID: | 266717 | Vaccination Date: | 2006-09-25 | | Age: | 37.0 | Onset Date: | 2006-09-30 Days later: 5 | | Gender: | Female | Submitted: | 0000-00-00 | | State: | Illinois | Entered: | 2006-11-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: OVCON | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0800F | | | | |
| Administered by: Private Purchased by: Private | | Symptoms: Rash | | Write-up: Developed rash all over body gradually subsided after few days. |
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| VAERS ID: | 266734 | Vaccination Date: | 2006-10-03 | | Age: | 14.0 | Onset Date: | 2006-10-06 Days later: 3 | | Gender: | Female | Submitted: | 2006-11-09 | | State: | California | Entered: | 2006-11-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: NONE | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0702F | 0 | IM | | |
| Administered by: Private Purchased by: Unknown | | Symptoms: Urticaria | | Write-up: Hives all over 3 days after injection. No treatment. |
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| VAERS ID: | 266774 | Vaccination Date: | 2006-10-12 | | Age: | 20.0 | Onset Date: | 2006-10-19 Days later: 7 | | Gender: | Female | Submitted: | 2006-11-14 | | State: | Louisiana | Entered: | 2006-11-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: None | | Diagnostic Lab Data: none | | Previous Vaccinations: | | Other Medications: Yaz, Zoloft, Bactrim DS | | Preexisting Conditions: Depression | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 08668F | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Injection site pain, Shoulder pain | | Write-up: Patient developed left shoulder pain at the deltoid corresponding to the site of injection. This began about 1 week after injection and has lasted for 3 weeks. It is 7/10 in severity and requires anti-inflammatories. |
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| VAERS ID: | 266788 | Vaccination Date: | 2006-11-13 | | Age: | 21.0 | Onset Date: | 2006-11-13 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-14 | | State: | Oregon | Entered: | 2006-11-14 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: odd cough & migranes per patient history | | Diagnostic Lab Data: n/a | | Previous Vaccinations: | | Other Medications: Advair | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Dizziness, Fatigue, Panic reaction | | Write-up: Patient c/o: dizziness, lightheaded, feels as if she is going to have a panic attack, very fatigued. |
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| VAERS ID: | 266889 | Vaccination Date: | 2006-10-25 | | Age: | 14.0 | Onset Date: | 2006-10-26 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-16 | | State: | Michigan | Entered: | 2006-11-16 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? Yes, days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: Labs: Glucose 118, CO2 21, C-reactive protein 1.8. | | Previous Vaccinations: | | Other Medications: Nasocort, Zyrtec, Allergy injections. | | Preexisting Conditions: Allergic Rhinitis. PMH: environmental allergens. Eczema. Roavirus at age 2 months. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | AVENTIS PASTEUR | U2256AA | | IM | UN | | HPV4 | MERCK & CO. INC. | 0955F | 0 | IM | UN | | MNQ | AVENTIS PASTEUR | U1948AA | 0 | IM | UN | | TDAP | GLAXOSMITHKLINE BIOLOGICALS | AC52B012AA | 0 | IM | UN | |
| Administered by: Private Purchased by: Private | | Symptoms: Dehydration, Hypersensitivity, Muscle spasms, Pyrexia | | Write-up: Pt received injections 10/25/06. Flu and HPV in one thigh. Tdap and Menactra in other thigh unk which thigh each given. Pt then went to allergist and received allergy injection in each arm. Admitted 10/26/06 for fever 103, dehydration and muscle cramping, sent home 10/27/06. DC DX: allergic reaction. 2 day history of fever. On same day as immunizations she received routine allergy shots. Immunizations received in thighs and allergy injections in arms. Complained of arms puffed and welted evening prior to admission, became painful. Also blotchiness on legs. Complained of pain in legs. Headache since immunizations, myalgias and arthralgias especially to shoulder area. Neck pain, prickly sensaton in feet. Previous immunization reacion 3 weeks ago with pain and symptomatic problems. PMH: environmental allergens. Eczema. Roavirus at age 2 months. PE: Extremities, there is injection site visible. No rash, erythema or exudate noted around the injection sites. No other rashes. |
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| VAERS ID: | 267030 | Vaccination Date: | 2006-11-15 | | Age: | 17.0 | Onset Date: | 2006-11-15 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-16 | | State: | Pennsylvania | Entered: | 2006-11-16 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: none | | Diagnostic Lab Data: none | | Previous Vaccinations: | | Other Medications: Adderall XL 30mg q day Depo Provera 150mg q 3 months | | Preexisting Conditions: NKA none | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0954F | 0 | IM | RA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Disorientation, Dyskinesia, Eye movement disorder, Pallor, Syncope | | Write-up: Within a minute of giving injection in rt deltoid, pt experienced pallor, syncope, rolling back of the eyes followed by jerky movements of upper & lower extremities. After 5 seconds, she became responsive, but disoriented to place. Pt stated that she had not eaten much all day. |
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| VAERS ID: | 267080 | Vaccination Date: | 2006-08-31 | | Age: | 19.0 | Onset Date: | 2006-10-03 Days later: 33 | | Gender: | Female | Submitted: | 2006-11-14 | | State: | Florida | Entered: | 2006-11-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? Yes, days | | Extended hospital stay? No |
| Current Illness: | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Insulin, Synthroid | | Preexisting Conditions: Diabetes, Hypothyroidism. | | CDC 'Split Type': WAES0611USA02762 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | | 0 | IM | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Abdominal pain, Feeling cold, Haemorrhage, Hot flush, Nausea, Pyrexia | | Write-up: concerning a 19 year old female with diabetes and hypothyroidism on 8/31/06 was vaccainted IM with a first dose of HPV vaccine. Concomitant therapy included an insulin pump, Levothyroxine (Synthroid) and (Loworval). On 10/3/06 (also reported as a month later), the pt experienced hot flushes and cold flashed, nausea, a temp less than 100F and abnormal bleeding. On 11/4/06, the pt experienced right lower quadrant abdominal pain and was hospitalized. She has had a CAT scan, MRI, laparoscopy and a few ultrasounds of the area but all have been neg. The pt was treated wit IV fluids. At the time of this report, the pt had not recovered. No product quality complaint was involved. Right lower quadrant abdominal pain was considered to be an other important medical event (OMIC). Additional information has been requested. |
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| VAERS ID: | 267100 | Vaccination Date: | 2006-11-08 | | Age: | 21.0 | Onset Date: | 2006-11-08 Days later: 0 | | Gender: | Female | Submitted: | 2006-11-10 | | State: | Minnesota | Entered: | 2006-11-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Nuvaring, Allegra D, Albuterol, Nasonex | | Preexisting Conditions: NONE | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Private | | Symptoms: Pruritus | | Write-up: Pt received vaccination early in AM. Called later that afternoon and was itching all over. took Benadryl which helped. |
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| VAERS ID: | 267171 | Vaccination Date: | 2006-11-10 | | Age: | 13.0 | Onset Date: | 2006-11-11 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-17 | | State: | Minnesota | Entered: | 2006-11-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: none | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: NONE | | Preexisting Conditions: none | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | FLU | AVENTIS PASTEUR | U2244AA | 1 | IM | LA | | HPV4 | MERCK & CO. INC. | 08668F | 0 | IM | RA | |
| Administered by: Unknown Purchased by: Unknown | | Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis | | Write-up: INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to move right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration. Received MR from pediatrician revealing a healthy 12 year old in for well-child exam. 24 hours after Flu and Gardasil vax. child developed numbness, pain, and inability to move the right side of face. Assessment: Facial Nerve Palsy-unclear etiology. Child was sent by car to Minneapolis Children's ER to be evaluated. ER report received: DX: Bell's Palsy |
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| VAERS ID: | 267197 | Vaccination Date: | 2006-11-13 | | Age: | 19.0 | Onset Date: | 2006-11-14 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-16 | | State: | Wisconsin | Entered: | 2006-11-17 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Well woman exam. C/o some discomfort in the mastoid area behind her right ear x2 days. | | Diagnostic Lab Data: Lymes, CBC, CRP, CMP, Sed rate. Labs and Diagnostics: All normal. | | Previous Vaccinations: | | Other Medications: ortho tricylic Meds-Ortho Tri-Cyclen | | Preexisting Conditions: None PMH: None noted except for dysmenorrhea. NKA. | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0688F | 0 | IM | LA | |
| Administered by: Private Purchased by: Other | | Symptoms: Facial palsy | | Write-up: Bell's Palsy right occurred 24 hours after injection of Gardasil. Previously healthy. MR received revealing an 18 yr. old in for well-woman exam with only c/o some discomfort in the mastoid area behind her right ear x2 days. The following day she presented with right-sided facial droop. HPI: Pt awoke morning following Gardasil vax. and had difficulty with spitting out her toothpaste. No pain or visual loss. No extremity weakness or paresthesias. Most obvious upon smiling. Able to wrinkle forehead and puff cheeks. Good sensation. Txd with Famvir, Solu-medrol and Refresh Tears. Assessment: Bell's Palsy. |
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| VAERS ID: | 267288 | Vaccination Date: | 2006-09-29 | | Age: | 25.0 | Onset Date: | 2006-09-30 Days later: 1 | | Gender: | Female | Submitted: | 2006-11-15 | | State: | Maryland | Entered: | 2006-11-20 | |
| Life Threatening Illness? Yes |
| Died? No |
| Disability? Yes |
| Recovered? Yes | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: Urinary tract infection | | Diagnostic Lab Data: | | Previous Vaccinations: | | Other Medications: Yasmin, Macrobid | | Preexisting Conditions: | | CDC 'Split Type': WAES0611USA03232 | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0800F | 0 | | UN | |
| Administered by: Other Purchased by: Other | | Symptoms: Throat tightness, Tongue oedema, Urticaria | | Write-up: Information has been received from a physicians assistant concerning a 25 year old female who on 9/29/06 was vaccinated with a first dose of HPV vaccine. Concomitant suspect therapy initiated a few days prior included nitrofurantoin (Macrobid) for the treatment of a urinary tract infection (dose not reported). Other concomitant therapy included drospirenone + ethinyl Estradiol (Yasmin). On 9/20/06 the pt called the physicians office to state that she had developed hives. The physicians office referred her to the ER where she was placed on methylprednisolone (Medrol Dosepak). The pt was not hospitalized. On 10/2/06 the pt called the physicians office to report that her tongue was swelling and her throat was closing. The pt was immediately referred to the ER where she was given epinephrine (Epi Pen). The pt was not hospitalized. On 1/04/06 the pt recovered. Hives, tongue swelling and throat closing were considered to be disabling, immediately life threatening and other important medical events (OMIC). The physicians assistant reported that they were not sure if the reactions was to the HPV or the Macrobid. Additional information has been requested. |
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| VAERS ID: | 267319 | Vaccination Date: | 2006-09-29 | | Age: | 19.0 | Onset Date: | 2006-10-08 Days later: 9 | | Gender: | Female | Submitted: | 2006-11-09 | | State: | Georga | Entered: | 2006-11-20 | |
| Life Threatening Illness? No |
| Died? No |
| Disability? No |
| Recovered? No | | ER or Doctor Visit? Yes |
| Hospitalized? No | | Current Illness: NONE | | Diagnostic Lab Data: Biopsy done on 11/9/06. | | Previous Vaccinations: | | Other Medications: | | Preexisting Conditions: | | CDC 'Split Type': | |
| Vaccination | Manufacturer | Lot | Dose | Route | Site | | HPV4 | MERCK & CO. INC. | 0954F | 0 | IM | LA | |
| Administered by: Other Purchased by: Private | | Symptoms: Pruritus, Rash | | Write-up: Pruritus - rash began on lower extremities 1.5 weeks following the first vaccine for HPV. The rash then spread to trunk, back and arms over the next week. Rash began as singular lesions which coalesced it places. |
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| VAERS ID: | 267409 | Vaccination Date: | 2006-09-18 | | Age: | 25.0 | Onset Date: | 2006-09-18 Days later: 0 | |