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This is VAERS ID 263754

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 263754
VAERS Form:
Age:26.0
Gender:Female
Location:Kentucky
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2006-09-25
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0702F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria

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: BUSPAR, ATIVAN, CELEXA
Current Illness: NONE
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: took two BENADRYL
CDC 'Split Type':

Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands.


Changed on 12/8/2009

VAERS ID: 263754 Before After
VAERS Form:
Age:26.0
Gender:Female
Location:Kentucky
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2006-09-25
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria

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: BUSPAR, ATIVAN, CELEXA
Current Illness: NONE
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: took two BENADRYL
CDC 'Split Type':

Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands.


Changed on 9/14/2017

VAERS ID: 263754 Before After
VAERS Form:(blank) 1
Age:26.0
Gender:Female
Location:Kentucky
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2006-09-25
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria

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: BUSPAR, ATIVAN, CELEXA
Current Illness: NONE
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: took two BENADRYL
CDC 'Split Type':

Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands.


Changed on 2/14/2018

VAERS ID: 263754 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Kentucky
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2006-09-25
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria

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: BUSPAR, ATIVAN, CELEXA
Current Illness: NONE
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: took two BENADRYL
CDC 'Split Type':

Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands.


Changed on 6/14/2018

VAERS ID: 263754 Before After
VAERS Form:1
Age:26.0
Gender:Female
Location:Kentucky
Vaccinated:2006-09-25
Onset:2006-09-25
Submitted:2006-09-25
Entered:2006-09-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site warmth, Pruritus, Urticaria

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: BUSPAR, ATIVAN, CELEXA
Current Illness: NONE
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: took two BENADRYL
CDC 'Split Type':

Write-up: Hives on neck and chest, injection site red, warm to touch, itching at area and on palms of hands.

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