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This is VAERS ID 272328

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272328
VAERS Form:
Age:12.0
Gender:Female
Location:New York
Vaccinated:2007-01-07
Onset:2007-01-07
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: diabetes, eczema
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 12 year old female with diabetes and eczema who on approximately 07-JAN-2007 was vaccinated with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) concomitantly with a dose of an unspecifie"d vaccine. On approximately 07-JAN-2007, later in the night, the patient developed hives all over her body, mostly on her legs. Unspecified medical attention was sought. At the time of the report, the patient''''s outcome was unknown. Additional informat


Changed on 12/8/2009

272328 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:New York
Vaccinated:2007-01-07
Onset:2007-01-07
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: diabetes, eczema
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0701USA01778

Write-up:Information has been received from a physician concerning a 12 year old female with diabetes and eczema who on approximately 07-JAN-2007 was vaccinated with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) concomitantly with a dose of an unspecifie"d unspecified vaccine. On approximately 07-JAN-2007, later in the night, the patient developed hives all over her body, mostly on her legs. Unspecified medical attention was sought. At the time of the report, the patient''''s patient''s outcome was unknown. Additional informat information has been requested.


Changed on 9/14/2017

272328 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:New York
Vaccinated:2007-01-07
Onset:2007-01-07
Submitted:2007-02-14
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: diabetes, eczema
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0701USA01778

Write-up:Information has been received from a physician concerning a 12 year old female with diabetes and eczema who on approximately 07-JAN-2007 was vaccinated with a 0.5 ml dose of HPV rL1 6 11 16 18 VLP vaccine (yeast) concomitantly with a dose of an unspecified vaccine. On approximately 07-JAN-2007, later in the night, the patient developed hives all over her body, mostly on her legs. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information has been requested.


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