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This is VAERS ID 367765

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 367765
VAERS Form:
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 9/14/2017

VAERS ID: 367765 Before After
VAERS Form:(blank) 1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 0 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 2/14/2018

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 6/14/2018

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 8/14/2018

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 9/14/2018

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 10/14/2018

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 12/24/2020

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 12/30/2020

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 5/7/2021

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.


Changed on 5/21/2021

VAERS ID: 367765 Before After
VAERS Form:1
Age:10.0
Sex:Female
Location:Foreign
Vaccinated:2009-10-06
Onset:2009-10-07
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA042AH / 1 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Dyspnoea, Injection site erythema, Injection site oedema, Pruritus, Rash morbilliform

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Allergic to mildew; Allergy to olives; Allergy to parietaria
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': B0603729A

Write-up: This case was reported by a physician and described the occurrence of morbilliform exanthema in a 10-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline). Concurrent medical conditions included allergic to mildew, allergy to olives and allergy to parietaria. On 6 October 2009, the subject received 1st dose of CERVARIX (intramuscular, right arm). On 7 October 2009, 12 hours after vaccination with CERVARIX, the subject experienced edema and erythema at injection site (right arm). In October 2009, 30 hours after vaccination with CERVARIX, the subject experienced morbilliform exanthema, itching and dyspnea. The physician considered the events were life threatening. At the time of reporting the events were resolved with sequelae. The physician considered the events were possibly related to vaccination with CERVARIX.

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