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This is VAERS ID 265808

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

265808
VAERS Form:
Age:21.0
Gender:Female
Location:Maryland
Vaccinated:2006-10-06
Onset:2006-10-07
Submitted:2006-10-30
Entered:2006-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0800F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chills, Nausea, Pyrexia, Vomiting

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: Estrostep
Current Illness: NONE
Preexisting Conditions: allergic to Penicillin.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Nausea and vomiting, fever 99 degrees F- 100 degrees F, chills for 3 days.


Changed on 12/8/2009

265808 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Maryland
Vaccinated:2006-10-06
Onset:2006-10-07
Submitted:2006-10-30
Entered:2006-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Chills, Nausea, Pyrexia, Vomiting

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: Estrostep
Current Illness: NONE
Preexisting Conditions: allergic to Penicillin.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Nausea and vomiting, fever 99 degrees F- 100 degrees F, chills for 3 days.


Changed on 9/14/2017

265808 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Maryland
Vaccinated:2006-10-06
Onset:2006-10-07
Submitted:2006-10-30
Entered:2006-11-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Chills, Nausea, Pyrexia, Vomiting

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: Estrostep
Current Illness: NONE
Preexisting Conditions: allergic to Penicillin.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Nausea and vomiting, fever 99 degrees F- 100 degrees F, chills for 3 days.


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