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This is VAERS ID 263212

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 263212
Age:19.0
Gender:Female
Location:Arkansas
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0689F / - - / SC

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type':

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 vacci"ne (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 sit


Changed on 12/8/2009

VAERS ID: 263212 Before After
Age:19.0
Gender:Female
Location:Arkansas
Vaccinated:2006-08-14
Onset:2006-08-14
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. 0689F / - - / SC

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0608USA04253

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 "the standard dose/" dose" of HPV rLi 6 11 16 18 VLP vacci"ne 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 patient''s face and not at the injection sit 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.


Changed on 2/5/2010

VAERS ID: 263212 Before After
Age:19.0 17.0
Gender:Female
Location:Arkansas
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - - / SC

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0608USA04253

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.


Changed on 6/14/2014

VAERS ID: 263212 Before After
Age:17.0
Gender:Female
Location:Arkansas
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - - / SC

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0608USA04253

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.


Changed on 5/14/2017

VAERS ID: 263212 Before After
Age:17.0
Gender:Female
Location:Arkansas
Vaccinated:2006-08-14
Onset:2006-08-14
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0689F / - - / SC

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0608USA04253

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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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263212&WAYBACKHISTORY=ON


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