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This is VAERS ID 273565

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273565
VAERS Form:
Age:20.0
Gender:Female
Location:Indiana
Vaccinated:2007-03-07
Onset:2007-03-07
Submitted:2007-03-07
Entered:2007-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest discomfort, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: demulen, ketek, aquatab
Current Illness: dry skin
Preexisting Conditions: allergy Tetracycline record received 3/9/07-prior HX tetracycline allergy.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 1 hour of receiving vaccination she developed diffuse urticaria. responded to injected benadryl and depomedrol. 03/09/07-records received. for DOS 3/7/07-developed whole body hives and itching, chest felt heavy. Current medication Ketek. PE: WNL e"xcept for confluent hives on arms


Changed on 12/8/2009

273565 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Indiana
Vaccinated:2007-03-07
Onset:2007-03-07
Submitted:2007-03-07
Entered:2007-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest discomfort, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: demulen, ketek, aquatab
Current Illness: dry skin
Preexisting Conditions: allergy Tetracycline record received 3/9/07-prior HX tetracycline allergy.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 1 hour of receiving vaccination she developed diffuse urticaria. responded to injected benadryl and depomedrol. 03/09/07-records received. for DOS 3/7/07-developed whole body hives and itching, chest felt heavy. Current medication Ketek. PE: WNL e"xcept except for confluent hives on arms


Changed on 5/14/2017

273565 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Indiana
Vaccinated:2007-03-07
Onset:2007-03-07
Submitted:2007-03-07
Entered:2007-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest discomfort, Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: demulen, ketek, aquatab
Current Illness: dry skin
Preexisting Conditions: allergy Tetracycline record received 3/9/07-prior HX tetracycline allergy.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 1 hour of receiving vaccination she developed diffuse urticaria. responded to injected benadryl and depomedrol. 03/09/07-records received. for DOS 3/7/07-developed whole body hives and itching, chest felt heavy. Current medication Ketek. PE: WNL except for confluent hives on arms


Changed on 9/14/2017

273565 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Indiana
Vaccinated:2007-03-07
Onset:2007-03-07
Submitted:2007-03-07
Entered:2007-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0187U / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Urticaria

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: demulen, ketek, aquatab
Current Illness: dry skin
Preexisting Conditions: allergy Tetracycline record received 3/9/07-prior HX tetracycline allergy.
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Within 1 hour of receiving vaccination she developed diffuse urticaria. responded to injected benadryl and depomedrol. 03/09/07-records received. for DOS 3/7/07-developed whole body hives and itching, chest felt heavy. Current medication Ketek. PE: WNL except for confluent hives on arms


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