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This is VAERS ID 276117

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276117
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Rash

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a female who was vaccinated intramuscularly with Gardasil (LOT# 656049/0187U). Subsequently the patient experiences an 8 inch rash on hip area. The patient sought medical attention. Addition"al information has been requested.


Changed on 12/8/2009

276117 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / - - / IM

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

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA00336

Write-up:Information has been received from a registered nurse concerning a female who was vaccinated intramuscularly with Gardasil (LOT# 656049/0187U). Subsequently the patient experiences an 8 inch rash on hip area. The patient sought medical attention. Addition"al Additional information has been requested.


Changed on 3/2/2010

276117 Before After
VAERS Form:
Age:(blank) 25.0
Gender:Female
Location:Unknown Pennsylvania
Vaccinated:0000-00-00 2007-03-01
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / - 0 - LA / IM

Administered by: Private Public      Purchased by: Other
Symptoms: Rash

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00336

Write-up:Information This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with Gardasil a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information has been requested. is not expected.


Changed on 4/7/2010

276117 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-03-01
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Rash, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00336

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information is not expected.


Changed on 6/14/2014

276117 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-03-01
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Rash, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00336

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information is not expected.


Changed on 5/14/2017

276117 Before After
VAERS Form:
Age:25.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-03-01
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Rash, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00336

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information is not expected.


Changed on 9/14/2017

276117 Before After
VAERS Form:(blank) 1
Age:25.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-03-01
Onset:0000-00-00
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 1 LA / IM

Administered by: Public      Purchased by: Other
Symptoms: Rash, 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00336

Write-up:This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a registered nurse concerning a 25 year old female teacher with asthma and hives when takes cefprozil who on 01-MAR-2007 was vaccinated intramuscularly in to left deltoid with a first dose of GARDASIL, (LOT# 656049/0187U). Concomitant therapy included montelukast sodium. Subsequently the patient experiences an 8 inch rash on hip area. The nurse reported that the patient developed hives from the therapy. The patient sought medical attention. The patient''s outcome was unknown. In follow-up it was indicated that patient reported 8" string of hives around left hip morning after she got the injection. Hives resolved with 25 mg BENADRYL. Hives had reoccurred several times since. The allergist felt above incident was coincidental with vaccine and unrelated. Patient will continue with series of GARDASIL. Additional information is not expected.


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