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This is VAERS ID 264753

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264753
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-09-11
Onset:2006-09-12
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 653735/0688F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pyrexia, Rash vesicular

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

Write-up:Information has been received from a physician concerning a 17 year old female with no history of varicella virus vaccine live vaccination and an unknown history of varicella, who on 11-SEP-2006 was vaccinated intramuscularly with a 0.5 ml dose of HPV rL1"6 11 16 18 VLP vaccine (yeast). There was no concomitant medication. The physician reported that on 12-SEP-2006 /"the next day, the patient developed a low grade fever and a vesicular rash on her neck and shoulders of about 15-20 lesions./" The patient wa


Changed on 12/8/2009

VAERS ID: 264753 Before After
Age:18.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-09-11
Onset:2006-09-12
Submitted:2006-10-13
Entered:2006-10-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 653735/0688F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pyrexia, Rash vesicular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness:
Preexisting Conditions: UNK
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0609USA04898

Write-up:Information has been received from a physician concerning a 17 year old female with no history of varicella virus vaccine live vaccination and an unknown history of varicella, who on 11-SEP-2006 was vaccinated intramuscularly with a 0.5 ml dose of HPV rL1"6 rL1 6 11 16 18 VLP vaccine (yeast). There was no concomitant medication. The physician reported that on 12-SEP-2006 /"the "the next day, the patient developed a low grade fever and a vesicular rash on her neck and shoulders of about 15-20 lesions./" lesions." The patient wa was treated with acetaminophen (TYLENOL). All of her symptoms resolved within 3-4 days (approximately 15-SEP-2006). Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264753&WAYBACKHISTORY=ON


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