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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 263740 |
VAERS Form: | |
Age: | 26.0 |
Sex: | 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.
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.
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.
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.
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.
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.
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.
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.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=263740&WAYBACKHISTORY=ON
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