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This is VAERS ID 274204

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274204
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

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

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: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a female (age unknown) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. The patient was administered Gardasil in one arm ant Tetanus vaccine in t"he other arm on the same day. On approximately 02-FEB-2007 the patient developed a rash on her whole body. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. At the time of this report, the outcome was unkno


Changed on 12/8/2009

274204 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

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

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: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0702USA01396

Write-up:Information has been received from a nurse practitioner concerning a female (age unknown) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. The patient was administered Gardasil in one arm ant Tetanus vaccine in t"he the other arm on the same day. On approximately 02-FEB-2007 the patient developed a rash on her whole body. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. At the time of this report, the outcome was unkno unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

274204 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised

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: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA01396

Write-up:Information has been received from a nurse practitioner concerning a female (age unknown) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. The patient was administered Gardasil in one arm ant Tetanus vaccine in the other arm on the same day. On approximately 02-FEB-2007 the patient developed a rash on her whole body. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. At the time of this report, the outcome was unknown. No product quality complaint was involved. Additional no additional information has been requested. is available.


Changed on 9/14/2017

274204 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:2007-02-02
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised

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: UNK
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0702USA01396

Write-up:Information has been received from a nurse practitioner concerning a female (age unknown) who, on an unspecified date, was vaccinated intramuscularly with a 0.5 ml dose of Gardasil. The patient was administered Gardasil in one arm ant Tetanus vaccine in the other arm on the same day. On approximately 02-FEB-2007 the patient developed a rash on her whole body. The patient sought unspecified medical attention. No laboratory diagnostic studies were performed. At the time of this report, the outcome was unknown. No product quality complaint was involved. no additional information is available.


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