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This is VAERS ID 289947

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 289947
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-14
Onset:0000-00-00
Submitted:2007-09-04
Entered:2007-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Skin exfoliation

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female with penicillin allergy who on 14-AUG-2007 was vaccinated intramuscularly (IM) with the first dose of Gardasil (Lot #654702/0011U). Subsequently, the patient experienced peelin"g of the skin on the palms of both hands and the soles of both feet. The physician felt that this incident had caused a significant disability because it was very painful for the patient to walk with the skin on the soles of her feet peeling off. As of 28


Changed on 12/8/2009

VAERS ID: 289947 Before After
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-14
Onset:0000-00-00
Submitted:2007-09-04
Entered:2007-09-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Skin exfoliation

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Penicillin allergy
Preexisting Conditions:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0708USA05255

Write-up:Information has been received from a physician concerning a 16 year old female with penicillin allergy who on 14-AUG-2007 was vaccinated intramuscularly (IM) with the first dose of Gardasil (Lot #654702/0011U). Subsequently, the patient experienced peelin"g peeling of the skin on the palms of both hands and the soles of both feet. The physician felt that this incident had caused a significant disability because it was very painful for the patient to walk with the skin on the soles of her feet peeling off. As of 28 28-AUG-2007, the patient had not recovered from the peeling of the skin on the palms of both hands and the soles of both feet. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=289947&WAYBACKHISTORY=ON


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