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This is VAERS ID 274215

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274215
VAERS Form:
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Injection site discolouration

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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into"the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injec


Changed on 12/8/2009

274215 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation, Injection site discolouration

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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0702USA02321

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into"the into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injec injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.


Changed on 3/2/2010

274215 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation, Injection site discolouration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? 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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: UNK Unknown
CDC 'Split Type': WAES0702USA02321

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.


Changed on 6/14/2014

274215 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation, Injection site discolouration

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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA02321

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.


Changed on 5/14/2017

274215 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation, Injection site discolouration

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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA02321

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.


Changed on 9/14/2017

274215 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:North Carolina
Vaccinated:2007-02-08
Onset:2007-02-11
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - UNK UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Erythema, Melanocytic naevus, Pain, Rash, Skin hyperpigmentation, Injection site discolouration

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: hormonal contraceptives
Current Illness: Asthma
Preexisting Conditions: Cervical intraepithelial neoplasia; Benign pigmented naevus excision
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA02321

Write-up:Information has been received from a physician concerning a 22 year old female with mild asthma and a history of CIN grade I (2003, 2005 and 2006) and a benign pigmented lesion removed from her inner thigh (2006) who on 08-FEB-2007 was vaccinated IM into the right arm with a 0.5 ml dose of Gardasil (yeast) (lot # 654535/0960F). Concomitant therapy included oral hormonal contraceptives (unspecified). Three on 11-FEB-2007 the patient developed two raised areas of hyperpigmented skin in the area of the injection site. The areas are 4 x 4 mm and 3 x 3 mm. The areas are described as are nevus like in appearance, linear, surrounded by erythema and painful. The patient is being evaluated for a "possible skin rash." The patient had not yet recovered from her experiences. Additional information has been requested.


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