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This is VAERS ID 276657

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276657
VAERS Form:
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

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

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination,"the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL). At the time of thi


Changed on 12/8/2009

276657 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Erythema multiforme, 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)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA02134

Write-up:Information has been received from a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination,"the vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''''s physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL). At the time of thi this report, the patient had not recovered. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

276657 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema multiforme, Rash generalised

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02134

Write-up:Information has been received from a physician and a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL). At the time of this report, the patient had not (MEDROL) and subsequently recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.


Changed on 6/14/2014

276657 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema multiforme, Rash generalised

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02134

Write-up:Information has been received from a physician and a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL) and subsequently recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.


Changed on 5/14/2017

276657 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema multiforme, Rash generalised

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02134

Write-up:Information has been received from a physician and a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL) and subsequently recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.


Changed on 9/14/2017

276657 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Alabama
Vaccinated:2007-03-08
Onset:2007-03-10
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Erythema multiforme, Rash generalised

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA02134

Write-up:Information has been received from a physician and a registered nurse concerning a 16 year old female with no medical history or allergies, who on 08-MAR-2007 was vaccinated with a second dose of Gardasil. There was no concomitant medication. Two days after vaccination, the patient developed a rash all over her body. On 12-MAR-2007 the patient went to her primary care physician''s office and was diagnosed with erythema multiforme. The patient was treated with a dose pack of methylprednisolone (MEDROL) and subsequently recovered. No product quality complaint was involved. Additional information has been requested. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276657&WAYBACKHISTORY=ON


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