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This is VAERS ID 269215

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 269215
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-09
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0697F / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Rash

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

Write-up:Information has been received from a physician concerning a 16 year old female with no known drug allergies who on 08 Nov 2006, at 4:00 PM, was vaccinated IM with the first dose of HPV vaccine. On 09 Nov 2006, the patient developed a drug rash. The patien"t sought unspecified medical attention. On 14 Nov 2006, the patient was recovered from the drug rash. Additional information is not expected.


Changed on 12/8/2009

VAERS ID: 269215 Before After
Age:16.0
Gender:Female
Location:New Jersey
Vaccinated:2006-11-08
Onset:2006-11-09
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0697F / 0 - / IM

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0611USA05796

Write-up:Information has been received from a physician concerning a 16 year old female with no known drug allergies who on 08 Nov 2006, at 4:00 PM, was vaccinated IM with the first dose of HPV vaccine. On 09 Nov 2006, the patient developed a drug rash. The patien"t patient sought unspecified medical attention. On 14 Nov 2006, the patient was recovered from the drug rash. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269215&WAYBACKHISTORY=ON


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