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This is VAERS ID 276119

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276119
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 ho"urs of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patie


Changed on 12/8/2009

276119 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA00367

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 ho"urs hours of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patie patient. Subsequently, the patient recovered in 1 day. Additional information has been requested.


Changed on 3/2/2010

276119 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown Massachusetts
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - - UN / IM

Administered by: Private      Purchased by: Other
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00367

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a nurse practitioner (N.P.) concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated IM with a dose of GARDASIL (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of GARDASIL administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not viewed by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information is not expected.


Changed on 6/14/2014

276119 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - UN / IM

Administered by: Private      Purchased by: Other
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00367

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a nurse practitioner (N.P.) concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated IM with a dose of GARDASIL (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of GARDASIL administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not viewed by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information is not expected.


Changed on 5/14/2017

276119 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - UN / IM

Administered by: Private      Purchased by: Other
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00367

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a nurse practitioner (N.P.) concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated IM with a dose of GARDASIL (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of GARDASIL administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not viewed by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information is not expected.


Changed on 9/14/2017

276119 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-02-26
Onset:2007-02-27
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - UNK UN / IM

Administered by: Private      Purchased by: Other
Symptoms: 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA00367

Write-up:Information has been received from a nurse practitioner concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated with Gardasil (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of Gardasil administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not seen by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information has been requested. This is in follow-up to report(s) previously submitted on 4/6/2007. Initial and follow-up information has been received from a nurse practitioner (N.P.) concerning a 24 year old female, with no pertinent medical history, who on 26-FEB-2007 was vaccinated IM with a dose of GARDASIL (LOT# 654702/0011U). There was no concomitant therapy. On 26-FEB-2007, within 24 hours of GARDASIL administration, the patient experienced a rash on her abdomen. The patient had phoned the office to report the rash. The rash was not viewed by the nurse practitioner or physician. No prescription medication therapy was provided to the patient. Subsequently, the patient recovered in 1 day. Additional information is not expected.


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