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This is VAERS ID 271161

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271161
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-12-04
Onset:2006-12-05
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0868F / 1 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a teenage female who on 04 Dec 2006 was vaccinated with the second dose of Gardasil (lot#653736/0868F), IM injection. Concomitant medication was not reported. On 05 Dec 2006, the patient developed"a rash on her forearms. The physician reported that the patient was seen by another physician in the office, who prescirbed Benadryl to treat the rash. The outcome of the event was not reported. Additional information has been requested.


Changed on 12/8/2009

271161 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-12-04
Onset:2006-12-05
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0868F / 1 - / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0701USA00119

Write-up:Information has been received from a physician concerning a teenage female who on 04 Dec 2006 was vaccinated with the second dose of Gardasil (lot#653736/0868F), IM injection. Concomitant medication was not reported. On 05 Dec 2006, the patient developed"a developed a rash on her forearms. The physician reported that the patient was seen by another physician in the office, who prescirbed Benadryl to treat the rash. The outcome of the event was not reported. Additional information has been requested.


Changed on 9/14/2017

271161 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
Vaccinated:2006-12-04
Onset:2006-12-05
Submitted:2007-01-16
Entered:2007-01-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0868F / 1 2 - / IM

Administered by: Private      Purchased by: Other
Symptoms: Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0701USA00119

Write-up:Information has been received from a physician concerning a teenage female who on 04 Dec 2006 was vaccinated with the second dose of Gardasil (lot#653736/0868F), IM injection. Concomitant medication was not reported. On 05 Dec 2006, the patient developed a rash on her forearms. The physician reported that the patient was seen by another physician in the office, who prescirbed Benadryl to treat the rash. The outcome of the event was not reported. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271161&WAYBACKHISTORY=ON


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