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This is VAERS ID 283958

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

283958
VAERS Form:
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-01-15
Onset:2007-01-22
Submitted:2007-10-08
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Dysmenorrhoea, Herpes zoster, Local reaction, Pain of skin, Rash erythematous, Scab

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: Unknown
Current Illness: Dysmenorrhea
Preexisting Conditions: Hodgkin''s disease; Chemotherapy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02730

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a history of Hodgkin''s disease (at the age of 12, patient was diagnosed with Hodgkin''s disease and went thru Chemotherapy), who was vaccinated a few weeks ago with Gardasil. The patient developed localized reaction like shingles after getting vaccine. Unspecified medical attention was sought. No additional information was provided. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a nurse practitioner concerning a 16 year old white female patient with Hodgkin''s disease (diagnosed at age 12 and went through Chemotherapy and illness at time of vaccination included dysmenorrhea) who on 15-JAN-2007 at 12:07, was vaccinated IM with a first 0.5 ml dose of GARDASIL. On 22-JAN-2007, one week after receiving the vaccine, the patient developed painful vesicles which lasted for six weeks. The patient described them as a painful cluster of red bumps that enlarged, blisters erupted followed by crusting over. It was reported that the patient was not seen for eight weeks after the injection and the vesicles were not verified by the staff. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 6/14/2014

283958 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-01-15
Onset:2007-01-22
Submitted:2007-10-08
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Dysmenorrhoea, Herpes zoster, Local reaction, Pain of skin, Rash erythematous, Scab

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: Unknown
Current Illness: Dysmenorrhea
Preexisting Conditions: Hodgkin''s disease; Chemotherapy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02730

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a history of Hodgkin''s disease (at the age of 12, patient was diagnosed with Hodgkin''s disease and went thru Chemotherapy), who was vaccinated a few weeks ago with Gardasil. The patient developed localized reaction like shingles after getting vaccine. Unspecified medical attention was sought. No additional information was provided. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a nurse practitioner concerning a 16 year old white female patient with Hodgkin''s disease (diagnosed at age 12 and went through Chemotherapy and illness at time of vaccination included dysmenorrhea) who on 15-JAN-2007 at 12:07, was vaccinated IM with a first 0.5 ml dose of GARDASIL. On 22-JAN-2007, one week after receiving the vaccine, the patient developed painful vesicles which lasted for six weeks. The patient described them as a painful cluster of red bumps that enlarged, blisters erupted followed by crusting over. It was reported that the patient was not seen for eight weeks after the injection and the vesicles were not verified by the staff. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 5/14/2017

283958 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-01-15
Onset:2007-01-22
Submitted:2007-10-08
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Dysmenorrhoea, Herpes zoster, Local reaction, Pain of skin, Rash erythematous, Scab

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: Unknown
Current Illness: Dysmenorrhea
Preexisting Conditions: Hodgkin''s disease; Chemotherapy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02730

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a history of Hodgkin''s disease (at the age of 12, patient was diagnosed with Hodgkin''s disease and went thru Chemotherapy), who was vaccinated a few weeks ago with Gardasil. The patient developed localized reaction like shingles after getting vaccine. Unspecified medical attention was sought. No additional information was provided. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a nurse practitioner concerning a 16 year old white female patient with Hodgkin''s disease (diagnosed at age 12 and went through Chemotherapy and illness at time of vaccination included dysmenorrhea) who on 15-JAN-2007 at 12:07, was vaccinated IM with a first 0.5 ml dose of GARDASIL. On 22-JAN-2007, one week after receiving the vaccine, the patient developed painful vesicles which lasted for six weeks. The patient described them as a painful cluster of red bumps that enlarged, blisters erupted followed by crusting over. It was reported that the patient was not seen for eight weeks after the injection and the vesicles were not verified by the staff. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.


Changed on 9/14/2017

283958 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Washington
Vaccinated:2007-01-15
Onset:2007-01-22
Submitted:2007-10-08
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Dysmenorrhoea, Herpes zoster, Local reaction, Pain of skin, Rash erythematous, Scab

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: Unknown
Current Illness: Dysmenorrhea
Preexisting Conditions: Hodgkin''s disease; Chemotherapy
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0705USA02730

Write-up:Information has been received from a nurse practitioner concerning a 16 year old female with a history of Hodgkin''s disease (at the age of 12, patient was diagnosed with Hodgkin''s disease and went thru Chemotherapy), who was vaccinated a few weeks ago with Gardasil. The patient developed localized reaction like shingles after getting vaccine. Unspecified medical attention was sought. No additional information was provided. This is in follow-up to report(s) previously submitted on 6/14/2007. Information has been received from a nurse practitioner concerning a 16 year old white female patient with Hodgkin''s disease (diagnosed at age 12 and went through Chemotherapy and illness at time of vaccination included dysmenorrhea) who on 15-JAN-2007 at 12:07, was vaccinated IM with a first 0.5 ml dose of GARDASIL. On 22-JAN-2007, one week after receiving the vaccine, the patient developed painful vesicles which lasted for six weeks. The patient described them as a painful cluster of red bumps that enlarged, blisters erupted followed by crusting over. It was reported that the patient was not seen for eight weeks after the injection and the vesicles were not verified by the staff. Unspecified medical attention was sought. No diagnostic laboratory studies were performed. Subsequently, the patient recovered. No product quality complaint was involved. Additional information is not expected.


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