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This is VAERS ID 279041

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279041
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-24
Onset:2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Genital rash, Vulvovaginal pruritus

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 12 year old female patient who on 24-MAR-2007 was vaccinated with a second dose of Gardasil. On 26-MAR-2007 the patient developed a rash around the genital area and vaginal itch. It was unknown w"hether the physician plan to administer the third dose. Unspecified medical attention was sought. At the time of this report, the patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

279041 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-24
Onset:2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Genital rash, Vulvovaginal pruritus

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA00365

Write-up:Information has been received from a physician concerning a 12 year old female patient who on 24-MAR-2007 was vaccinated with a second dose of Gardasil. On 26-MAR-2007 the patient developed a rash around the genital area and vaginal itch. It was unknown w"hether whether the physician plan to administer the third dose. Unspecified medical attention was sought. At the time of this report, the patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

279041 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-24
Onset:2007-03-26
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Genital rash, Vulvovaginal pruritus

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA00365

Write-up:Information has been received from a physician concerning a 12 year old female patient who on 24-MAR-2007 was vaccinated with a second dose of Gardasil. On 26-MAR-2007 the patient developed a rash around the genital area and vaginal itch. It was unknown whether the physician plan to administer the third dose. Unspecified medical attention was sought. At the time of this report, the patient''s outcome was unknown. Additional information has been requested.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279041&WAYBACKHISTORY=ON


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