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This is VAERS ID 263202

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 263202
Age:14.0
Gender:Female
Location:Colorado
Vaccinated:2006-08-03
Onset:2006-08-04
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus, Rash, Rash papular, Skin ulcer, Skin burning sensation

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CLARITIN, vitamins (unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: fever, CONCURRENT CONDITIONS: seasonal allergy
Diagnostic Lab Data: NONE
CDC 'Split Type':

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


Changed on 12/8/2009

VAERS ID: 263202 Before After
Age:14.0
Gender:Female
Location:Colorado
Vaccinated:2006-08-03
Onset:2006-08-04
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0637F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus, Rash, Rash papular, Skin ulcer, Skin burning sensation

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: CLARITIN, vitamins (unspecified)
Current Illness:
Preexisting Conditions: MEDICAL HISTORY: fever, CONCURRENT CONDITIONS: seasonal allergy
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0608USA01355

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 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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