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This is VAERS ID 276842

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276842
Age:23.0
Gender:Female
Location:Iowa
Vaccinated:2007-01-11
Onset:2007-01-12
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Rash pustular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO-TRI-CYCLEN
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a Nurse Practitioner (N.P.) concerning a 23 year old female with penicillin allergy who on 11-JAN-2007 was vaccinated IM with a first dose of Gardasil. Concomitant therapy included lot# 655619/1427F. Concomitant therapy"included Ortho-Tri-Cyclen. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with Proactiv solution. On 20-MAR-2007,


Changed on 12/8/2009

VAERS ID: 276842 Before After
Age:23.0
Gender:Female
Location:Iowa
Vaccinated:2007-01-11
Onset:2007-01-12
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash pustular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO-TRI-CYCLEN
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0703USA03963

Write-up:Information has been received from a Nurse Practitioner (N.P.) concerning a 23 year old female with penicillin allergy who on 11-JAN-2007 was vaccinated IM with a first dose of Gardasil. Concomitant therapy included lot# 655619/1427F. Concomitant therapy"included therapy included Ortho-Tri-Cyclen. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with Proactiv solution. On 20-MAR-2007, it was noted on examination that the lesions remained "about the same." Additional information has been requested.


Changed on 2/5/2010

VAERS ID: 276842 Before After
Age:23.0
Gender:Female
Location:Iowa
Vaccinated:2007-01-11
Onset:2007-01-12 2007-01-14
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash pustular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO-TRI-CYCLEN ORTHO TRI-CYCLEN LO; hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA03963

Write-up:Information has been received from a Nurse Practitioner (N.P.) concerning a 23 year old female with penicillin allergy who on 11-JAN-2007 was vaccinated IM with a first dose of Gardasil. Concomitant therapy included lot# 655619/1427F. Concomitant therapy included Ortho-Tri-Cyclen. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with Proactiv solution. On 20-MAR-2007, it was noted on examination that the lesions remained "about the same." Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 4/13/2007. Initial and follow up information has been received from a Nurse Practitioner (N.P.) concerning a 24 year old (previously reported as 23 year old) female patient with penicillin allergy who on 11-JAN-2007 was vaccinated IM into left deltoid with a first dose of GARDASIL lot# 655619/1427F. In follow up it was reported that patient was given second dose on 27-MAR-2007 and on 17-JUL-2007 received the third dose of GARDASIL. Concomitant therapy included ORTHO TRI-CYCLEN LO. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with PROACTIV solution. On 20-MAR-2007, it was noted on examination that the lesions on her arms had resolved but the remaining lesions remained "about the same". In follow up it was reported that patient had no shortness of breath, "nonpurited". The pustular type acne started about 3 days after the first immunization. She was seen at the doctor''s office on 20-MAR-2007 and was treated for acne and they changed her birth control pill (unspecified). There were no adverse events after the second and third dose. On 27-MAR-2007 patient recovered. Additional information is not expected.


Changed on 6/14/2014

VAERS ID: 276842 Before After
Age:23.0
Gender:Female
Location:Iowa
Vaccinated:2007-01-11
Onset:2007-01-14
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash pustular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN LO; hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA03963

Write-up:Information has been received from a Nurse Practitioner (N.P.) concerning a 23 year old female with penicillin allergy who on 11-JAN-2007 was vaccinated IM with a first dose of Gardasil. Concomitant therapy included lot# 655619/1427F. Concomitant therapy included Ortho-Tri-Cyclen. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with Proactiv solution. On 20-MAR-2007, it was noted on examination that the lesions remained "about the same." Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 4/13/2007. Initial and follow up information has been received from a Nurse Practitioner (N.P.) concerning a 24 year old (previously reported as 23 year old) female patient with penicillin allergy who on 11-JAN-2007 was vaccinated IM into left deltoid with a first dose of GARDASIL lot# 655619/1427F. In follow up it was reported that patient was given second dose on 27-MAR-2007 and on 17-JUL-2007 received the third dose of GARDASIL. Concomitant therapy included ORTHO TRI-CYCLEN LO. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with PROACTIV solution. On 20-MAR-2007, it was noted on examination that the lesions on her arms had resolved but the remaining lesions remained "about the same". In follow up it was reported that patient had no shortness of breath, "nonpurited". The pustular type acne started about 3 days after the first immunization. She was seen at the doctor''s office on 20-MAR-2007 and was treated for acne and they changed her birth control pill (unspecified). There were no adverse events after the second and third dose. On 27-MAR-2007 patient recovered. Additional information is not expected.


Changed on 5/14/2017

VAERS ID: 276842 Before After
Age:23.0
Gender:Female
Location:Iowa
Vaccinated:2007-01-11
Onset:2007-01-14
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash pustular

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: ORTHO TRI-CYCLEN LO; hormonal contraceptives
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type': WAES0703USA03963

Write-up:Information has been received from a Nurse Practitioner (N.P.) concerning a 23 year old female with penicillin allergy who on 11-JAN-2007 was vaccinated IM with a first dose of Gardasil. Concomitant therapy included lot# 655619/1427F. Concomitant therapy included Ortho-Tri-Cyclen. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with Proactiv solution. On 20-MAR-2007, it was noted on examination that the lesions remained "about the same." Additional information has been requested. 01/07/2008 This is in follow-up to report(s) previously submitted on 4/13/2007. Initial and follow up information has been received from a Nurse Practitioner (N.P.) concerning a 24 year old (previously reported as 23 year old) female patient with penicillin allergy who on 11-JAN-2007 was vaccinated IM into left deltoid with a first dose of GARDASIL lot# 655619/1427F. In follow up it was reported that patient was given second dose on 27-MAR-2007 and on 17-JUL-2007 received the third dose of GARDASIL. Concomitant therapy included ORTHO TRI-CYCLEN LO. The patient developed pustular lesions on her face, chest, umbilical area and bilateral upper extremities one and a half days after receiving the first injection. The patient self-treated with PROACTIV solution. On 20-MAR-2007, it was noted on examination that the lesions on her arms had resolved but the remaining lesions remained "about the same". In follow up it was reported that patient had no shortness of breath, "nonpurited". The pustular type acne started about 3 days after the first immunization. She was seen at the doctor''s office on 20-MAR-2007 and was treated for acne and they changed her birth control pill (unspecified). There were no adverse events after the second and third dose. On 27-MAR-2007 patient recovered. Additional information is not expected.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276842&WAYBACKHISTORY=ON


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