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This is VAERS ID 276688

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276688
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Skin lesion, Skin papilloma

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

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of Gardasil (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of Ga"rdasil. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic


Changed on 12/8/2009

276688 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Skin lesion, Skin papilloma

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:
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0703USA03119

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of Gardasil (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of Ga"rdasil. Gardasil. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested.


Changed on 3/2/2010

276688 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 UN LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Skin lesion, Skin papilloma

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: DIFFERIN
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03119

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of Gardasil GARDASIL (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of Gardasil. GARDASIL. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Information has been received from an advanced practice registered nurse concerning an 11 year old female with acne on 17-NOV-2006 was vaccinated IM with a first dose 0.5 ml of GARDASIL vaccine (lo#654741/0013U). On 02-FEB-2007 the patient was vaccinated IM, in the left arm with a second dose of 0.5 ml of GARDASIL vaccine (lot #653978/0955F0. Concomitant threrapy included DIFFERIN. Two weeks after receiving the second dose, the patient developed 12-13 warts on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information is not expected.


Changed on 6/14/2014

276688 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Skin lesion, Skin papilloma

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: DIFFERIN
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03119

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of GARDASIL (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of GARDASIL. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Information has been received from an advanced practice registered nurse concerning an 11 year old female with acne on 17-NOV-2006 was vaccinated IM with a first dose 0.5 ml of GARDASIL vaccine (lo#654741/0013U). On 02-FEB-2007 the patient was vaccinated IM, in the left arm with a second dose of 0.5 ml of GARDASIL vaccine (lot #653978/0955F0. Concomitant threrapy included DIFFERIN. Two weeks after receiving the second dose, the patient developed 12-13 warts on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information is not expected.


Changed on 5/14/2017

276688 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Skin lesion, Skin papilloma

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: DIFFERIN
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03119

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of GARDASIL (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of GARDASIL. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Information has been received from an advanced practice registered nurse concerning an 11 year old female with acne on 17-NOV-2006 was vaccinated IM with a first dose 0.5 ml of GARDASIL vaccine (lo#654741/0013U). On 02-FEB-2007 the patient was vaccinated IM, in the left arm with a second dose of 0.5 ml of GARDASIL vaccine (lot #653978/0955F0. Concomitant threrapy included DIFFERIN. Two weeks after receiving the second dose, the patient developed 12-13 warts on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information is not expected.


Changed on 9/14/2017

276688 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-02-02
Onset:2007-02-16
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0013U / 1 2 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Skin lesion, Skin papilloma

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: DIFFERIN
Current Illness: Acne
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0703USA03119

Write-up:Information has been received from a licensed practical nurse concerning an 11 year old female with acne who on 17-NOV-2006 was vaccinated IM with a first 0.5 ml dose of GARDASIL (lot# 654741/0013U). On 02-FEB-2007 the patient received a second dose of GARDASIL. Concomitant therapy included adaplalene (DIFFERIN). Two weeks after receiving the second dose, the patient developed wart-like lesions on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. This is in follow-up to report (s) previously submitted on 4/13/2007. Information has been received from an advanced practice registered nurse concerning an 11 year old female with acne on 17-NOV-2006 was vaccinated IM with a first dose 0.5 ml of GARDASIL vaccine (lo#654741/0013U). On 02-FEB-2007 the patient was vaccinated IM, in the left arm with a second dose of 0.5 ml of GARDASIL vaccine (lot #653978/0955F0. Concomitant threrapy included DIFFERIN. Two weeks after receiving the second dose, the patient developed 12-13 warts on her hands. It was reported that the physician arranged a dermatologist consult for the patient. No diagnostic laboratory studies were involved. At the time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information is not expected.


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