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This is VAERS ID 275373

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275373
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-22
Onset:2007-03-24
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pruritus, Rash, Rash macular, Rash pruritic

Life Threatening? No
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: Albuterol inhaler, Prevacid
Current Illness: on 3/22/07 for epistaxis S/P trauma nose
Preexisting Conditions: Allergy Codeine (GI upset), HX GERD and exercise induced asthma.
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Pt seen at office on 3/26/07 c/o itchy rash to face. Reports XS began 2 days previously. Seen by DR noted macular rash face and neck and ordered Benadryl, Prn.


Changed on 12/8/2009

275373 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-22
Onset:2007-03-24
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Pruritus, Rash, Rash macular, Rash pruritic

Life Threatening? No
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: Albuterol inhaler, Prevacid
Current Illness: on 3/22/07 for epistaxis S/P trauma nose
Preexisting Conditions: Allergy Codeine (GI upset), HX GERD and exercise induced asthma.
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) CT200705

Write-up:Pt seen at office on 3/26/07 c/o itchy rash to face. Reports XS began 2 days previously. Seen by DR noted macular rash face and neck and ordered Benadryl, Prn.


Changed on 9/14/2017

275373 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Connecticut
Vaccinated:2007-03-22
Onset:2007-03-24
Submitted:2007-03-30
Entered:2007-04-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Pruritus, Rash, Rash macular, Rash pruritic

Life Threatening? No
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: Albuterol inhaler, Prevacid
Current Illness: on 3/22/07 for epistaxis S/P trauma nose
Preexisting Conditions: Allergy Codeine (GI upset), HX GERD and exercise induced asthma.
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': CT200705

Write-up:Pt seen at office on 3/26/07 c/o itchy rash to face. Reports XS began 2 days previously. Seen by DR noted macular rash face and neck and ordered Benadryl, Prn.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275373&WAYBACKHISTORY=ON


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