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This is VAERS ID 267319

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267319
VAERS Form:
Age:19.0
Gender:Female
Location:Georgia
Vaccinated:2006-09-29
Onset:2006-10-08
Submitted:2006-11-09
Entered:2006-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0954F / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Biopsy done on 11/9/06.
CDC 'Split Type':

Write-up:Pruritus - rash began on lower extremities 1.5 weeks following the first vaccine for HPV. The rash then spread to trunk, back and arms over the next week. Rash began as singular lesions which coalesced it places.


Changed on 12/8/2009

267319 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Georgia
Vaccinated:2006-09-29
Onset:2006-10-08
Submitted:2006-11-09
Entered:2006-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 LA / IM

Administered by: Other      Purchased by: Unknown Private
Symptoms: Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Biopsy done on 11/9/06.
CDC 'Split Type':

Write-up:Pruritus - rash began on lower extremities 1.5 weeks following the first vaccine for HPV. The rash then spread to trunk, back and arms over the next week. Rash began as singular lesions which coalesced it places.


Changed on 9/14/2017

267319 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Georgia
Vaccinated:2006-09-29
Onset:2006-10-08
Submitted:2006-11-09
Entered:2006-11-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 LA / IM

Administered by: Other      Purchased by: Private
Symptoms: Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Biopsy done on 11/9/06.
CDC 'Split Type':

Write-up:Pruritus - rash began on lower extremities 1.5 weeks following the first vaccine for HPV. The rash then spread to trunk, back and arms over the next week. Rash began as singular lesions which coalesced it places.


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