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This is VAERS ID 263235

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263235
VAERS Form:
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-24
Onset:2006-08-29
Submitted:2006-09-14
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 23 year old female who on approximately 24-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). On approximately 29-AUG-2006 (about 5 days after vaccination) the patient develope"d a rash (site of rash unspecified0. Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


Changed on 12/8/2009

263235 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-24
Onset:2006-08-29
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. - / - - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0608USA06869

Write-up:Information has been received from a physician concerning a 23 year old female who on approximately 24-AUG-2006 was vaccinated with HPV rLi 6 11 16 18 VLP vaccine (yeast). On approximately 29-AUG-2006 (about 5 days after vaccination) the patient develope"d developed a rash (site of rash unspecified0. Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


Changed on 1/5/2010

263235 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-24 2006-08-18
Onset:2006-08-29 2006-08-23
Submitted:2006-09-14 2007-01-05
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0637F / - - UN / IM

Administered by: Other Private      Purchased by: Other Private
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0608USA06869

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 who on approximately 24-AUG-2006 with no known drug allergies was vaccinated intramuscularly on 18-AUG-2006 at 15:00 in the deltoid muscle with HPV rLi 6 11 16 18 VLP vaccine GARDASIL (yeast). On approximately 29-AUG-2006 (about 5 days after vaccination) 24-AUG-2006 the patient developed a rash (site with itching and minimal swelling on the back of rash unspecified0. her neck, arms, ribs, back and behind her left knee. Unspecified medical attention Follow up information stated that the patient was sought. treated with Benadryl, 50 mg and topical hydrocortisone cream. At It was reported that on 24-AUG-2006 the time of this report, the outcome of the event was unknown. patient had recovered. Additional information has been requested. is not expected.


Changed on 6/14/2014

263235 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-18
Onset:2006-08-23
Submitted:2007-01-05
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / - UN / IM

Administered by: Private      Purchased by: Private
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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0608USA06869

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.


Changed on 5/14/2017

263235 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-18
Onset:2006-08-23
Submitted:2007-01-05
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / - UN / IM

Administered by: Private      Purchased by: Private
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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0608USA06869

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.


Changed on 9/14/2017

263235 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:North Carolina
Vaccinated:2006-08-18
Onset:2006-08-23
Submitted:2007-01-05
Entered:2006-09-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / - UNK UN / IM

Administered by: Private      Purchased by: Private
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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0608USA06869

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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