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This is VAERS ID 267996

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267996
VAERS Form:
Age:14.0
Gender: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.

Changed on 12/8/2009

VAERS ID: 267996 Before After
VAERS Form:
Age:14.0
Gender: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) 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.

Changed on 9/14/2017

VAERS ID: 267996 Before After
VAERS Form:(blank) 1
Age:14.0
Gender: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: 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.

Changed on 2/14/2018

VAERS ID: 267996 Before After
VAERS Form:1
Age:14.0
Gender: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: 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.

Changed on 6/14/2018

VAERS ID: 267996 Before After
VAERS Form:1
Age:14.0
Gender: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: 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.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=267996&WAYBACKHISTORY=ON


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