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This is VAERS ID 274123

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274123
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 19 year old female with a penicillin allergy. On 01-FEB-2007, at 11:00 AM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant the"rapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention.


Changed on 12/8/2009

274123 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness:
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA00727

Write-up:Information has been received from a registered nurse concerning a 19 year old female with a penicillin allergy. On 01-FEB-2007, at 11:00 AM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant the"rapy therapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention. The physician prescribed over-the-counter Benadryl and contacted the patient the next day for follow up. The patient reported that she was fine. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested.


Changed on 3/2/2010

274123 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / - UN

Administered by: Other Private      Purchased by: Other Private
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness: Penicillin allergy
Preexisting Conditions: Penicillin allergy
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00727

Write-up:Information has been received from a registered nurse concerning a 19 year old female student (63 inches, 112 lbs) with no illness at the time of vaccination and with a penicillin allergy. On 01-FEB-2007, at 11:00 AM, approximately 14:00 PM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant therapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention. The physician prescribed over-the-counter Benadryl and contacted the patient the next day for follow up. The patient reported that she was fine. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested. Additional infromation is not expected.


Changed on 6/14/2014

274123 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00727

Write-up:Information has been received from a registered nurse concerning a 19 year old female student (63 inches, 112 lbs) with no illness at the time of vaccination and with a penicillin allergy. On 01-FEB-2007, at approximately 14:00 PM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant therapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention. The physician prescribed over-the-counter Benadryl and contacted the patient the next day for follow up. The patient reported that she was fine. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested. Additional infromation is not expected.


Changed on 5/14/2017

274123 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00727

Write-up:Information has been received from a registered nurse concerning a 19 year old female student (63 inches, 112 lbs) with no illness at the time of vaccination and with a penicillin allergy. On 01-FEB-2007, at approximately 14:00 PM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant therapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention. The physician prescribed over-the-counter Benadryl and contacted the patient the next day for follow up. The patient reported that she was fine. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested. Additional infromation is not expected.


Changed on 9/14/2017

274123 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:New Jersey
Vaccinated:2007-02-01
Onset:2007-02-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Injection site rash, Rash

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: Yasmin
Current Illness: Penicillin allergy
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA00727

Write-up:Information has been received from a registered nurse concerning a 19 year old female student (63 inches, 112 lbs) with no illness at the time of vaccination and with a penicillin allergy. On 01-FEB-2007, at approximately 14:00 PM, the patient was vaccinated in the left arm with the first 0.5 mL dose of HPV (lot# 655619/1427F). Concomitant therapy included Yasmin. On that same day, at 4:00 PM, the patient developed a rash on her left arm from the injection site to the elbow and a rash also on her right arm (unspecified where on her right arm). The patient sought unspecified medical attention. The physician prescribed over-the-counter Benadryl and contacted the patient the next day for follow up. The patient reported that she was fine. At the time of this report, the patient had recovered from the event (date unknown). Additional information has been requested. Additional infromation is not expected.


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