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This is VAERS ID 263930

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263930
VAERS Form:
Age:21.0
Gender:Female
Location:Rhode Island
Vaccinated:2006-09-28
Onset:2006-09-28
Submitted:2006-10-03
Entered:2006-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 08001F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site warmth, Pain, Pyrexia

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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.


Changed on 12/8/2009

263930 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Rhode Island
Vaccinated:2006-09-28
Onset:2006-09-28
Submitted:2006-10-03
Entered:2006-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 08001F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Injection site warmth, Pain, Pyrexia

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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.


Changed on 6/13/2012

263930 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Rhode Island
Vaccinated:2006-09-28
Onset:2006-09-28
Submitted:2006-10-03
Entered:2006-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08001F / 0 LA / IM

Administered by: Unknown Military      Purchased by: Unknown Military
Symptoms: Injection site warmth, Pain, Pyrexia

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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.


Changed on 9/14/2017

263930 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Rhode Island
Vaccinated:2006-09-28
Onset:2006-09-28
Submitted:2006-10-03
Entered:2006-10-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08001F / 0 1 LA / IM

Administered by: Military      Purchased by: Military
Symptoms: Injection site warmth, Pain, Pyrexia

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:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:FEVER, SITE WARM TO TOUCH, PAIN NOTED WITH MOVEMENT OF EXTREMITY.


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