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This is VAERS ID 284542

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284542
VAERS Form:
Age:13.0
Gender:Female
Location:California
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: 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: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 13 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed a bad rash after the vaccination. The patient visited and urgent care center for unspecified tre"atment. The patient''''s outcome was unknown. Additional information has been requested.


Changed on 12/8/2009

284542 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
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: 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: Unknown
CDC 'Split Type': (blank) WAES0705USA05764

Write-up:Information has been received from a physician concerning a 13 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed a bad rash after the vaccination. The patient visited and urgent care center for unspecified tre"atment. treatment. The patient''''s patient''s outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

284542 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
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. - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: 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: Unknown
CDC 'Split Type': WAES0705USA05764

Write-up:Information has been received from a physician concerning a 13 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed a bad rash after the vaccination. The patient visited and urgent care center for unspecified treatment. The patient''s outcome was unknown. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284542&WAYBACKHISTORY=ON


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