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This is VAERS ID 261575

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

261575
VAERS Form:
Age:24.0
Gender:Female
Location:California
Vaccinated:2006-07-12
Onset:2006-07-12
Submitted:2006-08-10
Entered:2006-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DPP: DIPHTHERIA TOXOID/PERTUSSIS/POLIO VIRUS, INACT. / UNKNOWN MANUFACTURER - / - - / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

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). Conco"mitant 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 h


Changed on 12/8/2009

261575 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:California
Vaccinated:2006-07-12
Onset:2006-07-12
Submitted:2006-08-10
Entered:2006-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DPP: DIPHTHERIA TOXOID/PERTUSSIS/POLIO VIRUS, INACT. / UNKNOWN MANUFACTURER - / - - / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - - / -
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0607USA041063

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/" "last week" on approximately 12-JUL-2006 was vaccinated with HPV vaccine rLI 6 11 16 18 VLP vaccine (yeast) (0.5 ml). Conco"mitant Concomitant therapy that day included diphtheria toxoid (+) pertussis acellular vaccine (unspecified) (+) tetanus toxoid. The vaccines were administered in different arms. Subsequently, /"12 "12 hours after vaccination/" vaccination" the patient developed a rash throughout h 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.


Changed on 9/14/2017

261575 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:California
Vaccinated:2006-07-12
Onset:2006-07-12
Submitted:2006-08-10
Entered:2006-08-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0607USA041063

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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