National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 272081

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272081
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Lethargy, Nausea, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Benadryl, Prevacid, Nasacort
Current Illness:
Preexisting Conditions: Asthma, Penicillin allergy, Drug Hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomita"nt therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was


Changed on 12/8/2009

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Lethargy, Nausea, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Benadryl, Prevacid, Nasacort
Current Illness:
Preexisting Conditions: Asthma, Penicillin allergy, Drug Hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomita"nt Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested.


Changed on 1/5/2010

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0011U / - 0 UN / - UN

Administered by: Other Private      Purchased by: Other Private
Symptoms: Lethargy, Nausea, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes No
Recovered? No Yes
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: Benadryl, Prevacid, Nasacort Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions: Asthma, Penicillin allergy, Drug Hypersensitivity
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks.


Changed on 7/31/2010

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis, Erythema, Lethargy, Nausea, Rash papular, Rash pruritic, Skin lesion, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks.


Changed on 1/4/2011

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis, Erythema, Lethargy, Nausea, Rash papular, Rash pruritic, Skin lesion, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks. The patient did not seek medical attention for the hives. At the time of the report, the patient recovered. The dermatologist felt that since the patient may have a sensitivity to beans and other legumes this may be the source of the eruption. The physician considered the events to be non-serious (previously reported as disabling events by the registered nurse). No further information is available. This report no longer meets the criteria for expidited submission to the FDA. Follow-up information reported that the events were considered to be non serious. Medical records are available upon request.


Changed on 6/14/2014

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis, Erythema, Lethargy, Nausea, Rash papular, Rash pruritic, Skin lesion, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks. The patient did not seek medical attention for the hives. At the time of the report, the patient recovered. The dermatologist felt that since the patient may have a sensitivity to beans and other legumes this may be the source of the eruption. The physician considered the events to be non-serious (previously reported as disabling events by the registered nurse). No further information is available. This report no longer meets the criteria for expidited submission to the FDA. Follow-up information reported that the events were considered to be non serious. Medical records are available upon request.


Changed on 5/14/2017

272081 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis, Erythema, Lethargy, Nausea, Rash papular, Rash pruritic, Skin lesion, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks. The patient did not seek medical attention for the hives. At the time of the report, the patient recovered. The dermatologist felt that since the patient may have a sensitivity to beans and other legumes this may be the source of the eruption. The physician considered the events to be non-serious (previously reported as disabling events by the registered nurse). No further information is available. This report no longer meets the criteria for expidited submission to the FDA. Follow-up information reported that the events were considered to be non serious. Medical records are available upon request.


Changed on 9/14/2017

272081 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-01-25
Onset:2007-01-26
Submitted:2007-02-09
Entered:2007-02-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Dermatitis, Erythema, Lethargy, Nausea, Rash papular, Rash pruritic, Skin lesion, Urticaria

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Benadryl; Prevacid; Nasacort; Ovar; Prevacid; Xopenex
Current Illness: Concurrent conditions: Asthma; Pennicillin allergy; allergy to legumes; Drug Hypersensitivity; Ehlers- Oanlos syndrome
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00186

Write-up:Information has been received from a registered nurse concerning her 11 year old daughter with asthma, penicillin allergy and drug hypersensitivity to cephalexin (KEFLEX) who on 25-JAN-2007 was vaccinated with a dose of Gardasil vaccine (yeast). Concomitant therapy included lansoprazole (PREVACID), triamcinolone acetonide (NASACORT) and diphenhydramine HCl (BENADRYL). On 26-JAN-2007 the patient developed nausea, lethargy and a rash with pruritus on back. Unspecified medical attention was sought. There was no laboratory or diagnostic tests performed. At the time of the report, the patient was recovering. The registered nurse considered nausea, lethargy and pruritic rash to be disabling events. Additional information has been requested. This is in follow-up to report (s) previously submitted on 2/9/2007; 5/28/2007. On 26-Jan-2007, it was reported that the patient "may have had swollen glands in her neck area." On 27-Jan-2007 the patient experienced lethargy. On 28-Jan-2007, the patient developed nausea and a rash with pruritus on back. The paiten took BENADRYL and "felt that this helped." On 30-Jan-2007, the patient was seen by a dermatologist, fulll cutaneous examination revealed that the left scapular back had a diffuse area of scale and erythema. the right upper abdomen had on 0.6 cm erythematous lesion with a central erythematous papule. The left abdomen had2 similar 0.6 cm lesions that were slightly more urticarial in their erythema. the remainder of the complete cutaneous examination failed to reveal any additional nuspicion or active lesions. Impression include dermatitis, fever papular urticaria and to consider hypersensitivity. The patient was treated with CUTIVATE. The dermatologist did not feel that the reaction was necessarily related to GARDASIL and recommended that she compete her vaccination course. On 29-Mar-2007, the patient was vaccinated with her second dose of GARDASIL ("lot # 02446"). The patient''s mother, a registered nurse reported that she developed hives on her forearms, trunk and buttocks. The patient did not seek medical attention for the hives. At the time of the report, the patient recovered. The dermatologist felt that since the patient may have a sensitivity to beans and other legumes this may be the source of the eruption. The physician considered the events to be non-serious (previously reported as disabling events by the registered nurse). No further information is available. This report no longer meets the criteria for expidited submission to the FDA. Follow-up information reported that the events were considered to be non serious. Medical records are available upon request.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272081&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166