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This is VAERS ID 267435

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267435
Age:22.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 22 year old female who on 11-Oct-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653978/0955F) (0.5ml), intramuscularly. Concomitant therapy included ethinyl estradiol/norges"timate (ORTHO TRI-CYCLEN). On 12-Oct-2006 the patient experienced /"rash on her face and neck/". 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

VAERS ID: 267435 Before After
Age:22.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-10-11
Onset:2006-10-12
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / - - / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0610USA09303

Write-up:Information has been received from a physician concerning a 22 year old female who on 11-Oct-2006 was vaccinated with HPV rL1 6 11 16 18 VLP vaccine (yeast) (lot#653978/0955F) (0.5ml), intramuscularly. Concomitant therapy included ethinyl estradiol/norges"timate estradiol/norgestimate (ORTHO TRI-CYCLEN). On 12-Oct-2006 the patient experienced /"rash "rash on her face and neck/". neck". Unspecified medical attention was sought. At the time of this report, the outcome of the event was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267435&WAYBACKHISTORY=ON


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