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This is VAERS ID 276243

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276243
VAERS Form:
Age:
Gender:Female
Location:Florida
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. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Dermatitis allergic, Pityriasis rosea, 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)? No
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 medical assistant concerning a female with vaccinated with Gardasil. Subsequently the patient developed a rash on her arm and part of the face. The rash spread to the rest of the body. The patient was diagnosed with al"lergic dermatitis and pityriasis rosea. Patient outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

276243 Before After
VAERS Form:
Age:
Gender:Female
Location:Florida
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. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dermatitis allergic, Pityriasis rosea, 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)? No
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) WAES0703USA04287

Write-up:Information has been received from a medical assistant concerning a female with vaccinated with Gardasil. Subsequently the patient developed a rash on her arm and part of the face. The rash spread to the rest of the body. The patient was diagnosed with al"lergic allergic dermatitis and pityriasis rosea. Patient outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

276243 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Florida
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. - / - UNK UN / -

Administered by: Other      Purchased by: Other
Symptoms: Dermatitis allergic, Pityriasis rosea, 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)? No
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': WAES0703USA04287

Write-up:Information has been received from a medical assistant concerning a female with vaccinated with Gardasil. Subsequently the patient developed a rash on her arm and part of the face. The rash spread to the rest of the body. The patient was diagnosed with allergic dermatitis and pityriasis rosea. Patient outcome was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276243&WAYBACKHISTORY=ON


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