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This is VAERS ID 268992

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

268992
VAERS Form:
Age:14.0
Gender:Female
Location:Michigan
Vaccinated:2006-11-22
Onset:2006-11-30
Submitted:2006-12-15
Entered:2006-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0954F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Orthotrycyclen
Current Illness: Dysmonorrhea, Sinusitis
Preexisting Conditions: Allergy to Cephalosporins, Penicillin and Sulfa
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:One week after injection, pt. has had a patchy, dry, erythemous rash 1 cm. in circumference show up intermittently on trunk and extremities. Rash remits and recurs. No history of rash.


Changed on 12/8/2009

268992 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Michigan
Vaccinated:2006-11-22
Onset:2006-11-30
Submitted:2006-12-15
Entered:2006-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Orthotrycyclen
Current Illness: Dysmonorrhea, Sinusitis
Preexisting Conditions: Allergy to Cephalosporins, Penicillin and Sulfa
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:One week after injection, pt. has had a patchy, dry, erythemous rash 1 cm. in circumference show up intermittently on trunk and extremities. Rash remits and recurs. No history of rash.


Changed on 9/14/2017

268992 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Michigan
Vaccinated:2006-11-22
Onset:2006-11-30
Submitted:2006-12-15
Entered:2006-12-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Orthotrycyclen
Current Illness: Dysmonorrhea, Sinusitis
Preexisting Conditions: Allergy to Cephalosporins, Penicillin and Sulfa
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:One week after injection, pt. has had a patchy, dry, erythemous rash 1 cm. in circumference show up intermittently on trunk and extremities. Rash remits and recurs. No history of rash.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=268992&WAYBACKHISTORY=ON


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