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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 267996 |
VAERS Form: | |
Age: | 14.0 |
Sex: | Unknown |
Location: | Missouri |
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. | 0688F / - | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. | 0688F / - | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / - UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Vaccinated: | 2006-11-20 |
Onset: | 0000-00-00 |
Submitted: | 0000-00-00 |
Entered: | 2006-11-30 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0688F / UNK | LA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Pain
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: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: 2nd dose Patient complain of pain.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267996&WAYBACKHISTORY=ON
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