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This is VAERS ID 284517

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284517
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site pruritus, Injection site 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: 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 female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''''s rash at injection site and i"tching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 12/8/2009

284517 Before After
VAERS Form:
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Injection site pruritus, Injection site 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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0705USA05504

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''''s patient''s rash at injection site and i"tching itching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 3/2/2010

284517 Before After
VAERS Form:
Age:(blank) 23.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0089U / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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 Lactobacillus acidophilus; hormonal contraceptives
Current Illness: Sulfonamide allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05504

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a health professional concerning an approximately 23 year old female with a sulfa allergy and no other medical history who was vaccinated with a dose of GARDASIL (lot # 655324/0089U). Concomitant therapy included unspecified birth control pills and acidophilus. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site subsided with no treatment required. The patient told the nurse she will not complete the series at the office. No additional information was available. Additional information is not expected.


Changed on 6/14/2014

284517 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0089U / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash

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: Lactobacillus acidophilus; hormonal contraceptives
Current Illness: Sulfonamide allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05504

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a health professional concerning an approximately 23 year old female with a sulfa allergy and no other medical history who was vaccinated with a dose of GARDASIL (lot # 655324/0089U). Concomitant therapy included unspecified birth control pills and acidophilus. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site subsided with no treatment required. The patient told the nurse she will not complete the series at the office. No additional information was available. Additional information is not expected.


Changed on 5/14/2017

284517 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0089U / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash

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: Lactobacillus acidophilus; hormonal contraceptives
Current Illness: Sulfonamide allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05504

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a health professional concerning an approximately 23 year old female with a sulfa allergy and no other medical history who was vaccinated with a dose of GARDASIL (lot # 655324/0089U). Concomitant therapy included unspecified birth control pills and acidophilus. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site subsided with no treatment required. The patient told the nurse she will not complete the series at the office. No additional information was available. Additional information is not expected.


Changed on 9/14/2017

284517 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0089U / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Injection site pruritus, Injection site rash

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: Lactobacillus acidophilus; hormonal contraceptives
Current Illness: Sulfonamide allergy
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA05504

Write-up:Information has been received from a health professional concerning a female who was vaccinated with a dose of Gardasil. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site persisted. The patient sought unspecified medical attention. Additional information has been requested. 10/08/07 This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow up information has been received from a health professional concerning an approximately 23 year old female with a sulfa allergy and no other medical history who was vaccinated with a dose of GARDASIL (lot # 655324/0089U). Concomitant therapy included unspecified birth control pills and acidophilus. Subsequently the patient experienced rash at injection site and itching at injection site. The patient''s rash at injection site and itching at injection site subsided with no treatment required. The patient told the nurse she will not complete the series at the office. No additional information was available. Additional information is not expected.


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