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History of Changes from the VAERS Wayback Machine |
First Appeared on 12/31/2007 |
VAERS ID: | 271129 |
VAERS Form: | |
Age: | 19.0 |
Gender: | Female |
Location: | Pennsylvania |
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / - |
Administered by: Other Purchased by: Unknown
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type':
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml0. There was no concomitant medication. O"n 15-Dec-2006, following, vaccination, the patient developed a red itchy rash /"all over/". Unspecified medication attention was sought. At the time of this report the patient had not recovered. Additional information has been requested.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / - |
Administered by: Other Purchased by: Unknown Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': (blank) WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml0. There was no concomitant medication. O"n On 15-Dec-2006, following, vaccination, the patient developed a red itchy rash /"all over/". "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. Additional information has been requested.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / - UN |
Administered by: Other Purchased by: Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml0. ml). There was no concomitant medication. On 15-Dec-2006, following, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. Additional No additional information has been requested. is available.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml). There was no concomitant medication. On 15-Dec-2006, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. No additional information is available.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml). There was no concomitant medication. On 15-Dec-2006, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. No additional information is available.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / - UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml). There was no concomitant medication. On 15-Dec-2006, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. No additional information is available.
Vaccinated: | 2006-12-15 |
Onset: | 2006-12-15 |
Submitted: | 2007-01-16 |
Entered: | 2007-01-22 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | - / UNK | UN / UN |
Administered by: Other Purchased by: Other
Symptoms: Rash pruritic, Laboratory test
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: NONE
Current Illness:
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: diagnostic laboratory 12/??/06 - results not provided
CDC 'Split Type': WAES0612USA02967
Write-up: Information has been received from a physician concerning a 19 year old female with no persistent medical history or drug reactions/allergies, who on 15-Dec-2006 was vaccinated with Gardasil vaccine (yeast) (0.5 ml). There was no concomitant medication. On 15-Dec-2006, following vaccination, the patient developed a red itchy rash "all over". Unspecified medication attention was sought. At the time of this report the patient had not recovered. No additional information is available.
Link To This Search Result:
http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271129&WAYBACKHISTORY=ON
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