National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279509

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 279509
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-18
Onset:2007-04-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 UN / UN

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

Write-up:Information has been received from a physician concerning a 17 year old female patient who on 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 18-APR-2007 she was vaccinated with a second dose of Gardasil lot #654702/0011U and developed a rash"(site unknown) and hives. She was sent to Urgent care center. Patient would not receive the third dose of Gardasil based on her experience with the second injection. The outcome of the event was unknown. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 279509 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-18
Onset:2007-04-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 UN / UN

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0704USA04418

Write-up:Information has been received from a physician concerning a 17 year old female patient who on 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 18-APR-2007 she was vaccinated with a second dose of Gardasil lot #654702/0011U and developed a rash"(site rash (site unknown) and hives. She was sent to Urgent care center. Patient would not receive the third dose of Gardasil based on her experience with the second injection. The outcome of the event was unknown. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 279509 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-18
Onset:2007-04-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 UN / UN

Administered by: Other      Purchased by: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04418

Write-up:Information has been received from a physician concerning a 17 year old female patient who on 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 18-APR-2007 she was vaccinated with a second dose of Gardasil lot #654702/0011U and (lot #654702/0011U) 0.5 ml. On 18-APR-2007, the patient developed a rash (site unknown) and hives. She was sent to Urgent care center. Patient would not receive the third dose of Gardasil based on her experience with the second injection. The outcome of the event was unknown. Additional information has been requested. was received from the office manager who reported that the patient was not seen in thier office. The rash was reported by way of the patient''s father. He was told that his daughter should go to an urgent care facility to be seen. The office did not receive a call back nor a report. No additional information is available.


Changed on 6/14/2014

VAERS ID: 279509 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-18
Onset:2007-04-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 UN / UN

Administered by: Other      Purchased by: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04418

Write-up:Information has been received from a physician concerning a 17 year old female patient who on 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 18-APR-2007 she was vaccinated with a second dose of Gardasil (lot #654702/0011U) 0.5 ml. On 18-APR-2007, the patient developed a rash (site unknown) and hives. She was sent to Urgent care center. Patient would not receive the third dose of Gardasil based on her experience with the second injection. The outcome of the event was unknown. Additional information was received from the office manager who reported that the patient was not seen in thier office. The rash was reported by way of the patient''s father. He was told that his daughter should go to an urgent care facility to be seen. The office did not receive a call back nor a report. No additional information is available.


Changed on 5/14/2017

VAERS ID: 279509 Before After
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-18
Onset:2007-04-18
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 UN / UN

Administered by: Other      Purchased by: 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0704USA04418

Write-up:Information has been received from a physician concerning a 17 year old female patient who on 02-FEB-2007 was vaccinated with a first dose of Gardasil. On 18-APR-2007 she was vaccinated with a second dose of Gardasil (lot #654702/0011U) 0.5 ml. On 18-APR-2007, the patient developed a rash (site unknown) and hives. She was sent to Urgent care center. Patient would not receive the third dose of Gardasil based on her experience with the second injection. The outcome of the event was unknown. Additional information was received from the office manager who reported that the patient was not seen in thier office. The rash was reported by way of the patient''s father. He was told that his daughter should go to an urgent care facility to be seen. The office did not receive a call back nor a report. No additional information is available.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279509&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166