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This is VAERS ID 276163

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276163
VAERS Form:
Age:
Gender:Female
Location:Missouri
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. - / 1 - / IM

Administered by: Other      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: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the"2nd injection. In both instances, the rash was isolated to only the patient''''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improvi


Changed on 12/8/2009

276163 Before After
VAERS Form:
Age:
Gender:Female
Location:Missouri
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. - / 1 - / IM

Administered by: Other      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: Unknown
CDC 'Split Type': (blank) WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the"2nd the 2nd injection. In both instances, the rash was isolated to only the patient''''s patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improvi improving as of the report date. Additional information has been requested.


Changed on 3/2/2010

276163 Before After
VAERS Form:
Age:(blank) 24.0
Gender:Female
Location:Missouri
Vaccinated:0000-00-00 2006-10-31
Onset:0000-00-00 2006-11-14
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0955F / 1 0 - / IM

Administered by: Other Private      Purchased by: Other Private
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: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the 2nd injection. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improving as of the report date. Additional information has been requested. Information has been received from a physician concerning a 24 year old female patient with a penicillin allergy who was vaccinated with a first dose of GARDASIL (lot #653978/0955P) intramuscularly in the left deltoid on 31-OCT-2206. About one and a half to two weeks after the first injection, on approximately 14-NOV-2006, the patient developed a rash on her face. On 05-JAN-2007, she was vaccinated with a second dose of GARDASIL (lot #6548851/1424F) intramuscularly in the left deltoid. On 18-JAN-2007, she developed a more extensive rash on her face. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention wsa sought. The patient was instructed to take BENADRYL as needed. The patient had recovered as of the report date. The patient was unable to keep an appointment for evaluation. Additional information has been requested.


Changed on 4/7/2010

276163 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-31
Onset:2006-11-14
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Vaccine positive rechallenge

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: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the 2nd injection. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improving as of the report date. Additional information has been requested. Information has been received from a physician concerning a 24 year old female patient with a penicillin allergy who was vaccinated with a first dose of GARDASIL (lot #653978/0955P) intramuscularly in the left deltoid on 31-OCT-2206. About one and a half to two weeks after the first injection, on approximately 14-NOV-2006, the patient developed a rash on her face. On 05-JAN-2007, she was vaccinated with a second dose of GARDASIL (lot #6548851/1424F) intramuscularly in the left deltoid. On 18-JAN-2007, she developed a more extensive rash on her face. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention wsa sought. The patient was instructed to take BENADRYL as needed. The patient had recovered as of the report date. The patient was unable to keep an appointment for evaluation. Additional information has been requested.


Changed on 6/14/2014

276163 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-31
Onset:2006-11-14
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Vaccine positive rechallenge

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: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the 2nd injection. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improving as of the report date. Additional information has been requested. Information has been received from a physician concerning a 24 year old female patient with a penicillin allergy who was vaccinated with a first dose of GARDASIL (lot #653978/0955P) intramuscularly in the left deltoid on 31-OCT-2206. About one and a half to two weeks after the first injection, on approximately 14-NOV-2006, the patient developed a rash on her face. On 05-JAN-2007, she was vaccinated with a second dose of GARDASIL (lot #6548851/1424F) intramuscularly in the left deltoid. On 18-JAN-2007, she developed a more extensive rash on her face. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention wsa sought. The patient was instructed to take BENADRYL as needed. The patient had recovered as of the report date. The patient was unable to keep an appointment for evaluation. Additional information has been requested.


Changed on 5/14/2017

276163 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-31
Onset:2006-11-14
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Vaccine positive rechallenge

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: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the 2nd injection. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improving as of the report date. Additional information has been requested. Information has been received from a physician concerning a 24 year old female patient with a penicillin allergy who was vaccinated with a first dose of GARDASIL (lot #653978/0955P) intramuscularly in the left deltoid on 31-OCT-2206. About one and a half to two weeks after the first injection, on approximately 14-NOV-2006, the patient developed a rash on her face. On 05-JAN-2007, she was vaccinated with a second dose of GARDASIL (lot #6548851/1424F) intramuscularly in the left deltoid. On 18-JAN-2007, she developed a more extensive rash on her face. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention wsa sought. The patient was instructed to take BENADRYL as needed. The patient had recovered as of the report date. The patient was unable to keep an appointment for evaluation. Additional information has been requested.


Changed on 9/14/2017

276163 Before After
VAERS Form:(blank) 1
Age:24.0
Gender:Female
Location:Missouri
Vaccinated:2006-10-31
Onset:2006-11-14
Submitted:2007-04-06
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash, Vaccine positive rechallenge

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: Penicillin allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA01054

Write-up:Information has been received from a physician concerning a female patient who was vaccinated with a first and second dose of Gardasil. The patient developed a rash on her face after 1st injection. She developed a more extensive rash on her face after the 2nd injection. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention was sought. The patient was improving as of the report date. Additional information has been requested. Information has been received from a physician concerning a 24 year old female patient with a penicillin allergy who was vaccinated with a first dose of GARDASIL (lot #653978/0955P) intramuscularly in the left deltoid on 31-OCT-2206. About one and a half to two weeks after the first injection, on approximately 14-NOV-2006, the patient developed a rash on her face. On 05-JAN-2007, she was vaccinated with a second dose of GARDASIL (lot #6548851/1424F) intramuscularly in the left deltoid. On 18-JAN-2007, she developed a more extensive rash on her face. In both instances, the rash was isolated to only the patient''s face. The physician was not planning to vaccinate the patient with the 3rd dose due to the adverse experience. Unspecified medical attention wsa sought. The patient was instructed to take BENADRYL as needed. The patient had recovered as of the report date. The patient was unable to keep an appointment for evaluation. Additional information has been requested.


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