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This is VAERS ID 279917

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279917
VAERS Form:
Age:17.0
Gender:Female
Location:Minnesota
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Rash, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Depo Provera (given 5/7/07)
Current Illness: no
Preexisting Conditions: LSIL PAP on 11-15-06.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient received Gardasil dose #1 Friday(5/25/07) and developed pinpoint, intensely pruritic rash on thighs to knees. Did not extend up onto trunk, did not extend below knees. Presented to clinic this afternoon (first day open after holiday) with concern.


Changed on 12/8/2009

279917 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Minnesota
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Rash, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Depo Provera (given 5/7/07)
Current Illness: no
Preexisting Conditions: LSIL PAP on 11-15-06.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient received Gardasil dose #1 Friday(5/25/07) and developed pinpoint, intensely pruritic rash on thighs to knees. Did not extend up onto trunk, did not extend below knees. Presented to clinic this afternoon (first day open after holiday) with concern.


Changed on 9/14/2017

279917 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Minnesota
Vaccinated:2007-05-25
Onset:2007-05-25
Submitted:2007-05-29
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Rash, Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Depo Provera (given 5/7/07)
Current Illness: no
Preexisting Conditions: LSIL PAP on 11-15-06.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient received Gardasil dose #1 Friday(5/25/07) and developed pinpoint, intensely pruritic rash on thighs to knees. Did not extend up onto trunk, did not extend below knees. Presented to clinic this afternoon (first day open after holiday) with concern.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279917&WAYBACKHISTORY=ON


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