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This is VAERS ID 263740

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 263740
VAERS Form:
Age:26.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-09-21
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / -

Administered by: Private      Purchased by: Unknown
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control Seasonal
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back.

Changed on 12/8/2009

VAERS ID: 263740 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-09-21
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control Seasonal
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back.

Changed on 9/14/2017

VAERS ID: 263740 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-09-21
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control Seasonal
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back.

Changed on 2/14/2018

VAERS ID: 263740 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-09-21
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control Seasonal
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back.

Changed on 6/14/2018

VAERS ID: 263740 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Missouri
Vaccinated:2006-09-01
Onset:2006-09-08
Submitted:2006-09-21
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 UN / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Birth Control Seasonal
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Itchy bumps, 1 on arm, 1 on breast, 1 on back.

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