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This is VAERS ID 284527

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284527
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash, Urticaria

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 physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 2"9-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''''s significant rash and hives persisted. No lab testing was performed. Additional information has been requested.


Changed on 12/8/2009

284527 Before After
VAERS Form:
Age:24.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Rash, Urticaria

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) WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 2"9-MAY-2007. 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''''s patient''s significant rash and hives persisted. No lab testing was performed. Additional information has been requested.


Changed on 3/2/2010

284527 Before After
VAERS Form:
Age:24.0 23.0
Gender:Female
Location:Unknown Missouri
Vaccinated:2007-05-29
Onset:2007-05-30 2007-05-29
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

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

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: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''s significant rash and hives persisted. No lab testing was performed. 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 physician and a health care professional concerning a 23 year old female who in 2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL. There were no adverse events. The second GARDASIL (Lot # 657622/0388U) 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 29-MAY-2007, the patient experienced injection site warmth, redness, and hives around the site. The outcome of the patient''s injection site redness, warmth and hives was unknown. Additional information is not expected.


Changed on 4/7/2010

284527 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Missouri
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria, Injection site warmth, Rash, Urticaria

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': WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''s significant rash and hives persisted. No lab testing was performed. 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 physician and a health care professional concerning a 23 year old female who in 2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL. There were no adverse events. The second GARDASIL (Lot # 657622/0388U) 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 29-MAY-2007, the patient experienced injection site warmth, redness, and hives around the site. The outcome of the patient''s injection site redness, warmth and hives was unknown. Additional information is not expected.


Changed on 6/14/2014

284527 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Missouri
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria, Injection site warmth, Rash, Urticaria

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': WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''s significant rash and hives persisted. No lab testing was performed. 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 physician and a health care professional concerning a 23 year old female who in 2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL. There were no adverse events. The second GARDASIL (Lot # 657622/0388U) 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 29-MAY-2007, the patient experienced injection site warmth, redness, and hives around the site. The outcome of the patient''s injection site redness, warmth and hives was unknown. Additional information is not expected.


Changed on 5/14/2017

284527 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Missouri
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria, Injection site warmth, Rash, Urticaria

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': WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''s significant rash and hives persisted. No lab testing was performed. 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 physician and a health care professional concerning a 23 year old female who in 2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL. There were no adverse events. The second GARDASIL (Lot # 657622/0388U) 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 29-MAY-2007, the patient experienced injection site warmth, redness, and hives around the site. The outcome of the patient''s injection site redness, warmth and hives was unknown. Additional information is not expected.


Changed on 9/14/2017

284527 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Missouri
Vaccinated:2007-05-29
Onset:2007-05-29
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 2 - / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site urticaria, Injection site warmth, Rash, Urticaria

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': WAES0705USA05701

Write-up:Information has been received from a physician concerning a 24 year old female who in 2007 was vaccinated with the first dose of 0.5 ml Gardasil intramuscularly. There were no adverse events. The second Gardasil 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 30-MAY-2007 the patient experienced significant rash and hives. The patient''s significant rash and hives persisted. No lab testing was performed. 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 physician and a health care professional concerning a 23 year old female who in 2007 was vaccinated intramuscularly with the first 0.5 ml dose of the GARDASIL. There were no adverse events. The second GARDASIL (Lot # 657622/0388U) 0.5 ml dose was given intramuscularly on 29-MAY-2007. On 29-MAY-2007, the patient experienced injection site warmth, redness, and hives around the site. The outcome of the patient''s injection site redness, warmth and hives was unknown. Additional information is not expected.


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