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This is VAERS ID 278994

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278994
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 LA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus, Rash generalised, Rash macular, Rash pruritic

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: none
Current Illness: none
Preexisting Conditions: Ankle sprain, no allergies, birth defects
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 4 hours of receiving vaccine in left arm, received rash (red, macular, lacy) which was itching and extended to rest of her body lasting 3-4 days.


Changed on 12/8/2009

278994 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 LA / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus, Rash generalised, Rash macular, Rash pruritic

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: none
Current Illness: none
Preexisting Conditions: Ankle sprain, no allergies, birth defects
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 4 hours of receiving vaccine in left arm, received rash (red, macular, lacy) which was itching and extended to rest of her body lasting 3-4 days.


Changed on 9/14/2017

278994 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-18
Entered:2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 LA / -

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash generalised, Rash macular, Rash pruritic

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: none
Current Illness: none
Preexisting Conditions: Ankle sprain, no allergies, birth defects
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 4 hours of receiving vaccine in left arm, received rash (red, macular, lacy) which was itching and extended to rest of her body lasting 3-4 days.


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