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This is VAERS ID 263370

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263370
VAERS Form:
Age:22.0
Gender:Female
Location:Kansas
Vaccinated:2006-08-24
Onset:2006-08-25
Submitted:2006-09-21
Entered:2006-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 0 GM / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Breast disorder female, Tenderness

Life Threatening? No
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: Ortho Tri cyclen LO x 6 years.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Extreme Breast tenderness x 4 days.


Changed on 12/8/2009

263370 Before After
VAERS Form:
Age:22.0
Gender:Female
Location:Kansas
Vaccinated:2006-08-24
Onset:2006-08-25
Submitted:2006-09-21
Entered:2006-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 GM / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Breast disorder female, Tenderness

Life Threatening? No
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: Ortho Tri cyclen LO x 6 years.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Extreme Breast tenderness x 4 days.


Changed on 9/14/2017

263370 Before After
VAERS Form:(blank) 1
Age:22.0
Gender:Female
Location:Kansas
Vaccinated:2006-08-24
Onset:2006-08-25
Submitted:2006-09-21
Entered:2006-09-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 1 GM / IM

Administered by: Private      Purchased by: Other
Symptoms: Breast disorder female, Tenderness

Life Threatening? No
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: Ortho Tri cyclen LO x 6 years.
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Extreme Breast tenderness x 4 days.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263370&WAYBACKHISTORY=ON


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