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This is VAERS ID 267782

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267782
VAERS Form:
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2006-11-13
Onset:2006-11-13
Submitted:2006-11-13
Entered:2006-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0702F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: 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: Effexor XR
Current Illness: Dyspnea; Tonsillitis
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Overall fine body rash for past 2 days. Pt has a concomitant tonsillitis onset 2 days ago - negative strep


Changed on 12/8/2009

267782 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2006-11-13
Onset:2006-11-13
Submitted:2006-11-13
Entered:2006-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: 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: Effexor XR
Current Illness: Dyspnea; Tonsillitis
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Overall fine body rash for past 2 days. Pt has a concomitant tonsillitis onset 2 days ago - negative strep


Changed on 9/14/2017

267782 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Alabama
Vaccinated:2006-11-13
Onset:2006-11-13
Submitted:2006-11-13
Entered:2006-11-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0702F / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: 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: Effexor XR
Current Illness: Dyspnea; Tonsillitis
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Overall fine body rash for past 2 days. Pt has a concomitant tonsillitis onset 2 days ago - negative strep


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