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This is VAERS ID 279059

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279059
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-01
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: 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: Unk
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Information has been received from a nurse practitioner, via a company representative, concerning a 15 year old female patient, who on 01-FEB-2007 was vaccinated with the first dose of Gardasil (Lot # 655503/0012U). There was no concomitant medication. On"02-FEB-2007, within 24 hours after the vaccination, the patient developed a rash on the arm and trunk. On approximately 04-FEB-2007 (/"48 hours later/") the patient''''s rash spread to the legs. The nurse practitioner stated that the rash /"lasted 2 weeks w


Changed on 12/8/2009

279059 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-01
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: 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: Unk
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type': (blank) WAES0704USA00739

Write-up:Information has been received from a nurse practitioner, via a company representative, concerning a 15 year old female patient, who on 01-FEB-2007 was vaccinated with the first dose of Gardasil (Lot # 655503/0012U). There was no concomitant medication. On"02-FEB-2007, On 02-FEB-2007, within 24 hours after the vaccination, the patient developed a rash on the arm and trunk. On approximately 04-FEB-2007 (/"48 ("48 hours later/") later") the patient''''s patient''s rash spread to the legs. The nurse practitioner stated that the rash /"lasted "lasted 2 weeks w with no fever or itching," and confirmed that the patient had recovered from the rash. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

279059 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-01
Onset:2007-02-02
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unk
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type': WAES0704USA00739

Write-up:Information has been received from a nurse practitioner, via a company representative, concerning a 15 year old female patient, who on 01-FEB-2007 was vaccinated with the first dose of Gardasil (Lot # 655503/0012U). There was no concomitant medication. On 02-FEB-2007, within 24 hours after the vaccination, the patient developed a rash on the arm and trunk. On approximately 04-FEB-2007 ("48 hours later") the patient''s rash spread to the legs. The nurse practitioner stated that the rash "lasted 2 weeks with no fever or itching," and confirmed that the patient had recovered from the rash. The patient sought unspecified medical attention. Additional information has been requested.


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