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This is VAERS ID 275604

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 275604
VAERS Form:
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': non

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given


Changed on 12/8/2009

VAERS ID: 275604 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': non (blank)

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given


Changed on 5/14/2017

VAERS ID: 275604 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified~3~~In specified (no brand name)~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given


Changed on 9/14/2017

VAERS ID: 275604 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified (no brand name)~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given


Changed on 2/14/2018

VAERS ID: 275604 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified (no brand name)~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given


Changed on 6/14/2018

VAERS ID: 275604 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-14
Onset:2007-03-23
Submitted:2007-04-04
Entered:2007-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER 0961F / 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Oral herpes

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: cold sore sore~Vaccine not specified (no brand name)~3~~In Patient
Other Medications:
Current Illness: URI
Preexisting Conditions: non
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Developed a cold sore on her upper Right Vermilion after Gardasil given

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275604&WAYBACKHISTORY=ON


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