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This is VAERS ID 271016

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271016
VAERS Form:
Age:19.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-17
Onset:2007-01-17
Submitted:2007-01-17
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dizziness, Flank pain, Nausea

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: Multivitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O severe L flank pain with nausea, dizziness 10 min after receiving vaccine.


Changed on 12/8/2009

271016 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-17
Onset:2007-01-17
Submitted:2007-01-17
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Dizziness, Flank pain, Nausea

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: Multivitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O severe L flank pain with nausea, dizziness 10 min after receiving vaccine.


Changed on 9/14/2017

271016 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Pennsylvania
Vaccinated:2007-01-17
Onset:2007-01-17
Submitted:2007-01-17
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Dizziness, Flank pain, Nausea

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: Multivitamin
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt C/O severe L flank pain with nausea, dizziness 10 min after receiving vaccine.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271016&WAYBACKHISTORY=ON


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