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This is VAERS ID 281020

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 281020
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-21
Onset:2007-05-21
Submitted:2007-06-07
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus, Rash

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 physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medic"ation. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient


Changed on 12/8/2009

VAERS ID: 281020 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-21
Onset:2007-05-21
Submitted:2007-06-07
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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) WAES0705USA05241

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medic"ation. medication. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient noticed the rash and mild itching the day that the vaccination was given. The patient was given cetirizine hydrochloride (ZYRTEC). At the time of this report, the patient''s rash and itching persisted. The reporting physician felt that the events were serious for another other medical event due to treatment with cetirizine hydrochloride (ZYRTEC). Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 281020 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-21
Onset:2007-05-21
Submitted:2007-06-07
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash

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': WAES0705USA05241

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medication. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient noticed the rash and mild itching the day that the vaccination was given. The patient was given cetirizine hydrochloride (ZYRTEC). At the time of this report, the patient''s rash and itching persisted. The reporting physician felt that the events were serious for another other medical event due to treatment with cetirizine hydrochloride (ZYRTEC). Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 281020 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-05-21
Onset:2007-05-21
Submitted:2007-06-07
Entered:2007-06-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Pruritus, Rash

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': WAES0705USA05241

Write-up: Information has been received from a physician concerning a 15 year old female with no pertinent medical history or drug reactions/allergies, who on 21-MAY-2007 was vaccinated intramuscularly with the first dose of Gardasil. There was no concomitant medication. On 21-MAY-2007 the patient developed a rash that started on the belly and spread to the back and both legs. The physician noted that it was unknown whether the rash was already there before the patient received the vaccination, however the patient noticed the rash and mild itching the day that the vaccination was given. The patient was given cetirizine hydrochloride (ZYRTEC). At the time of this report, the patient''s rash and itching persisted. The reporting physician felt that the events were serious for another other medical event due to treatment with cetirizine hydrochloride (ZYRTEC). Additional information has been requested.


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