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This is VAERS ID 264703

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264703
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Acne, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tricylen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Rash/Pimple like on fact and neck.


Changed on 12/8/2009

VAERS ID: 264703 Before After
Age:
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Acne, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tricylen
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Rash/Pimple like on fact and neck.


Changed on 3/2/2010

VAERS ID: 264703 Before After
Age:(blank) 21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho tricylen ORTHO TRI-CYCLEN
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Rash/Pimple like on fact and neck. This is in follow-up to report (s) previously submitted on 11/14/2006. Initial and follow-up information has been received from a health professional concerning a 23 year old female with no known allergies who on 11-OCT-2006 at 9:00 was vaccinated with a second dose of GARDASIL (lot # 653978/0955P), intramusculary in the deltoid. Concomitant therapy included ORTHO TRI-CYCLEN. On 12-OCT-2006 at 9:00 AM the patient experienced ''face/neck rash, pimple like stinging.'' It was also received from the FDA through the Freedom of Information Act. There is no additional information. Additional information has been requested.


Changed on 4/7/2010

VAERS ID: 264703 Before After
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Rash

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

Write-up:Rash/Pimple like on fact and neck. This is in follow-up to report (s) previously submitted on 11/14/2006. Initial and follow-up information has been received from a health professional concerning a 23 year old female with no known allergies who on 11-OCT-2006 at 9:00 was vaccinated with a second dose of GARDASIL (lot # 653978/0955P), intramusculary in the deltoid. Concomitant therapy included ORTHO TRI-CYCLEN. On 12-OCT-2006 at 9:00 AM the patient experienced ''face/neck rash, pimple like stinging.'' It was also received from the FDA through the Freedom of Information Act. There is no additional information. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 264703 Before After
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Rash

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

Write-up:Rash/Pimple like on fact and neck. This is in follow-up to report (s) previously submitted on 11/14/2006. Initial and follow-up information has been received from a health professional concerning a 23 year old female with no known allergies who on 11-OCT-2006 at 9:00 was vaccinated with a second dose of GARDASIL (lot # 653978/0955P), intramusculary in the deltoid. Concomitant therapy included ORTHO TRI-CYCLEN. On 12-OCT-2006 at 9:00 AM the patient experienced ''face/neck rash, pimple like stinging.'' It was also received from the FDA through the Freedom of Information Act. There is no additional information. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 264703 Before After
Age:21.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-10-12
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Rash

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

Write-up:Rash/Pimple like on fact and neck. This is in follow-up to report (s) previously submitted on 11/14/2006. Initial and follow-up information has been received from a health professional concerning a 23 year old female with no known allergies who on 11-OCT-2006 at 9:00 was vaccinated with a second dose of GARDASIL (lot # 653978/0955P), intramusculary in the deltoid. Concomitant therapy included ORTHO TRI-CYCLEN. On 12-OCT-2006 at 9:00 AM the patient experienced ''face/neck rash, pimple like stinging.'' It was also received from the FDA through the Freedom of Information Act. There is no additional information. Additional information has been requested.


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