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This is VAERS ID 279063

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279063
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-11
Onset:2007-01-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Rash, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: dicloxacillin
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC 'Split Type':

Write-up:Information has been received from a physician (allergist) concerning a female between 18 to 20 years old who on 11-JAN-2007 was vaccinated with first dose of Gardasil. Concomitant therapy included dicloxacillin from 04-JAN-2007 to 14-JAN-2007. On 28-JAN-"2007, the patient developed a hives rash over her arms and legs when administered the vaccine. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 279063 Before After
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-01-11
Onset:2007-01-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: dicloxacillin
Current Illness:
Preexisting Conditions: Unk
Diagnostic Lab Data: Unk
CDC 'Split Type': (blank) WAES0704USA00770

Write-up:Information has been received from a physician (allergist) concerning a female between 18 to 20 years old who on 11-JAN-2007 was vaccinated with first dose of Gardasil. Concomitant therapy included dicloxacillin from 04-JAN-2007 to 14-JAN-2007. On 28-JAN-"2007, 28-JAN-2007, the patient developed a hives rash over her arms and legs when administered the vaccine. The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279063&WAYBACKHISTORY=ON


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