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This is VAERS ID 279188

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279188
VAERS Form:
Age:10.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-13
Onset:2007-03-16
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / - - / ID

Administered by: Other      Purchased by: Unknown
Symptoms: Rash generalised, Rash papular, 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:
Preexisting Conditions: Migraine
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 10 year old female with a history of migraines who on 13-MAR-2007 was vaccinated with Gardasil. There was no concomitant medication. On approximately 16-MAR-2007, ''''within 3 to 4 days/", the pati"ent developed an itchy, papular rash on her face, extremities and body. The patient sought medical attention and was treated with Benadryl. Subsequently, the patient was recovering. The product quality complaint unit was not involved. Additional informati


Changed on 12/8/2009

279188 Before After
VAERS Form:
Age:10.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-13
Onset:2007-03-16
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / - - / ID

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash generalised, Rash papular, 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:
Preexisting Conditions: Migraine
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA01654

Write-up:Information has been received from a physician concerning a 10 year old female with a history of migraines who on 13-MAR-2007 was vaccinated with Gardasil. There was no concomitant medication. On approximately 16-MAR-2007, ''''within ''within 3 to 4 days/", days", the pati"ent patient developed an itchy, papular rash on her face, extremities and body. The patient sought medical attention and was treated with Benadryl. Subsequently, the patient was recovering. The product quality complaint unit was not involved. Additional informati information has been requested. The physician also provided information regarding another patient''s experience with Gardasil (WAES#0704USA01626).


Changed on 9/14/2017

279188 Before After
VAERS Form:(blank) 1
Age:10.0
Gender:Female
Location:Unknown
Vaccinated:2007-03-13
Onset:2007-03-16
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / - UNK - / ID

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised, Rash papular, 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:
Preexisting Conditions: Migraine
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA01654

Write-up:Information has been received from a physician concerning a 10 year old female with a history of migraines who on 13-MAR-2007 was vaccinated with Gardasil. There was no concomitant medication. On approximately 16-MAR-2007, ''within 3 to 4 days", the patient developed an itchy, papular rash on her face, extremities and body. The patient sought medical attention and was treated with Benadryl. Subsequently, the patient was recovering. The product quality complaint unit was not involved. Additional information has been requested. The physician also provided information regarding another patient''s experience with Gardasil (WAES#0704USA01626).


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