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This is VAERS ID 284580

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284580
VAERS Form:
Age:15.0
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 15 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed bad rash. The patient visited an urgent care center for unspecified treatment. The patient''''s ou"tcome was unknown. Additional information has been requested. This is one of two reports received from the same source.


Changed on 12/8/2009

284580 Before After
VAERS Form:
Age:15.0
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) WAES0706USA01455

Write-up:Information has been received from a physician concerning a 15 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed bad rash. The patient visited an urgent care center for unspecified treatment. The patient''''s ou"tcome patient''s outcome was unknown. Additional information has been requested. This is one of two reports received from the same source.


Changed on 9/14/2017

284580 Before After
VAERS Form:(blank) 1
Age:15.0
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': WAES0706USA01455

Write-up:Information has been received from a physician concerning a 15 year old female who was vaccinated with a dose of Gardasil. Subsequently, the patient developed bad rash. The patient visited an urgent care center for unspecified treatment. The patient''s outcome was unknown. Additional information has been requested. This is one of two reports received from the same source.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=284580&WAYBACKHISTORY=ON


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