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This is VAERS ID 269170

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

269170
VAERS Form:
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type':

Write-up:Information has been received from a physician concerning the experience of another physician''''s patient. On an unspecified date, a 12 year old female was vaccinated with a dose of Gardasil (yeast). Subsequently the patient developed a rash on her arm. Un"specified medical attention was sought. At the time of the report, the patient''''s outcome was unknown. Additional information is not expected.


Changed on 12/8/2009

269170 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - - / -

Administered by: Other      Purchased by: Unknown Other
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': (blank) WAES0611USA01398

Write-up:Information has been received from a physician concerning the experience of another physician''''s physician''s patient. On an unspecified date, a 12 year old female was vaccinated with a dose of Gardasil (yeast). Subsequently the patient developed a rash on her arm. Un"specified Unspecified medical attention was sought. At the time of the report, the patient''''s patient''s outcome was unknown. Additional information is not expected.


Changed on 9/14/2017

269170 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-12-14
Entered:2006-12-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / -

Administered by: Other      Purchased by: Other
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: UNK
Current Illness:
Preexisting Conditions: UNK
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': WAES0611USA01398

Write-up:Information has been received from a physician concerning the experience of another physician''s patient. On an unspecified date, a 12 year old female was vaccinated with a dose of Gardasil (yeast). Subsequently the patient developed a rash on her arm. Unspecified medical attention was sought. At the time of the report, the patient''s outcome was unknown. Additional information is not expected.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=269170&WAYBACKHISTORY=ON


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