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This is VAERS ID 279226

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279226
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Rash erythematous

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007 was vaccinated with the first dose, 0.5ml, of Gardasil (Lot #654885/1424F). There was no concomitant medication."On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''''s chest, legs, arms and back. Treatment included a Medrol Dose Pak. At the time of this report, the pha


Changed on 12/8/2009

279226 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash erythematous

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: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0704USA03094

Write-up:Information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007 was vaccinated with the first dose, 0.5ml, of Gardasil (Lot #654885/1424F). There was no concomitant medication."On medication. On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''''s patient''s chest, legs, arms and back. Treatment included a Medrol Dose Pak. At the time of this report, the pha pharmacist confirmed the patient was recovering from the rash. Additional information has been requested.


Changed on 3/2/2010

279226 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown Texas
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 UN RA / UN IM

Administered by: Other      Purchased by: Other Public
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA03094

Write-up:Information Initial and follow up information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007 13-APR-2007, approximately 9:30am, was vaccinated IM in the right deltoid, with the first dose, 0.5ml, of Gardasil GARDASIL (Lot #654885/1424F). There was no concomitant medication. It was unknown if there was any illness at the time of vaccination. On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''s chest, legs, arms and back. Treatment included BENADRYL, with a Medrol Dose Pak. MEDROL DOSE PAK also prescribed. At the time of this report, the pharmacist confirmed the patient was recovering from the rash. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. At the time of this report, the pharmacyst confirmed the patient had recovered (date an duration not specified). No further information is expected.


Changed on 6/14/2014

279226 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Texas
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 RA / IM

Administered by: Other      Purchased by: Public
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA03094

Write-up:Initial and follow up information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007, approximately 9:30am, was vaccinated IM in the right deltoid, with the first dose, 0.5ml, of GARDASIL (Lot #654885/1424F). There was no concomitant medication. It was unknown if there was any illness at the time of vaccination. On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''s chest, legs, arms and back. Treatment included BENADRYL, with a MEDROL DOSE PAK also prescribed. At the time of this report, the pharmacist confirmed the patient was recovering from the rash. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. At the time of this report, the pharmacyst confirmed the patient had recovered (date an duration not specified). No further information is expected.


Changed on 5/14/2017

279226 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Texas
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 RA / IM

Administered by: Other      Purchased by: Public
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA03094

Write-up:Initial and follow up information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007, approximately 9:30am, was vaccinated IM in the right deltoid, with the first dose, 0.5ml, of GARDASIL (Lot #654885/1424F). There was no concomitant medication. It was unknown if there was any illness at the time of vaccination. On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''s chest, legs, arms and back. Treatment included BENADRYL, with a MEDROL DOSE PAK also prescribed. At the time of this report, the pharmacist confirmed the patient was recovering from the rash. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. At the time of this report, the pharmacyst confirmed the patient had recovered (date an duration not specified). No further information is expected.


Changed on 9/14/2017

279226 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Texas
Vaccinated:2007-04-13
Onset:2007-04-15
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 1 RA / IM

Administered by: Other      Purchased by: Public
Symptoms: Rash erythematous

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0704USA03094

Write-up:Initial and follow up information has been received from a pharmacist, concerning a 16 year old female patient with no pertinent medical history, who on 13-APR-2007, approximately 9:30am, was vaccinated IM in the right deltoid, with the first dose, 0.5ml, of GARDASIL (Lot #654885/1424F). There was no concomitant medication. It was unknown if there was any illness at the time of vaccination. On 15-APR-2007 the patient developed a full body rash. The pharmacist described the rash as not itchy but red, and noted it was located on the patient''s chest, legs, arms and back. Treatment included BENADRYL, with a MEDROL DOSE PAK also prescribed. At the time of this report, the pharmacist confirmed the patient was recovering from the rash. Additional information has been requested. This is in follow-up to report (s) previously submitted on 5/14/2007. At the time of this report, the pharmacyst confirmed the patient had recovered (date an duration not specified). No further information is expected.


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