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This is VAERS ID 274663

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274663
VAERS Form:
Age:9.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-08
Onset:2007-03-20
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Cyanosis, Joint swelling, Pharyngolaryngeal pain, Pyrexia, Abasia

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:fever, rash, swollen joints (ankles, elbows, shoulders), can''''t walk, sore throat, toes blue. Probable Serum sickness


Changed on 12/8/2009

274663 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-08
Onset:2007-03-20
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 RA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Cyanosis, Joint swelling, Pharyngolaryngeal pain, Pyrexia, Rash, Serum sickness, Abasia

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:fever, rash, swollen joints (ankles, elbows, shoulders), can''''t can''t walk, sore throat, toes blue. Probable Serum sickness


Changed on 9/14/2017

274663 Before After
VAERS Form:(blank) 1
Age:9.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-08
Onset:2007-03-20
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 2 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Cyanosis, Joint swelling, Pharyngolaryngeal pain, Pyrexia, Rash, Serum sickness, Abasia

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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:fever, rash, swollen joints (ankles, elbows, shoulders), can''t walk, sore throat, toes blue. Probable Serum sickness


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