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This is VAERS ID 279622

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279622
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Rash generalised, Vaccine positive rechallenge

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

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was v"accinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested.


Changed on 12/8/2009

279622 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash generalised, Vaccine positive rechallenge

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0704USA06044

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was v"accinated vaccinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested.


Changed on 3/2/2010

279622 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / - 0 - AR / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised, Vaccine positive rechallenge

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA06044

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was vaccinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. It was reported that the physician "did not administer the vaccine and does not have any follow up information to provide". Additional information is not available.


Changed on 6/14/2014

279622 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 AR / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised, Vaccine positive rechallenge

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA06044

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was vaccinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. It was reported that the physician "did not administer the vaccine and does not have any follow up information to provide". Additional information is not available.


Changed on 5/14/2017

279622 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 AR / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised, Vaccine positive rechallenge

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA06044

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was vaccinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. It was reported that the physician "did not administer the vaccine and does not have any follow up information to provide". Additional information is not available.


Changed on 9/14/2017

279622 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-05-14
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 AR / IM

Administered by: Other      Purchased by: Other
Symptoms: Rash generalised, Vaccine positive rechallenge

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0704USA06044

Write-up:Information has been received from a health professional concerning a 19 year old female who on 22-FEB-2007 was vaccinated, in the deltoid, with Gardasil. On 22-FEB-2007 the patient experienced mild rash all over her body. On 23-APR-2007 the patient was vaccinated with her second dose, IM injection in the right deltoid and developed a severe rash all over body. Additional information has been requested. 07/06/07 This is in follow-up to report(s) previously submitted on 5/14/2007. It was reported that the physician "did not administer the vaccine and does not have any follow up information to provide". Additional information is not available.


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