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This is VAERS ID 275951

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275951
VAERS Form:
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 00014 / 0 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Rash, Urticaria

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:
Current Illness:
Preexisting Conditions: Med allergy to Sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Broke out with rash and hives 4-7-07 x 3 days.


Changed on 12/8/2009

275951 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 00014 / 0 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 RA / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Rash, Urticaria

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:
Current Illness:
Preexisting Conditions: Med allergy to Sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Broke out with rash and hives 4-7-07 x 3 days.


Changed on 9/14/2017

275951 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-03
Onset:2007-04-07
Submitted:2007-04-10
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 00014 / 0 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 1 RA / -

Administered by: Private      Purchased by: Private
Symptoms: Rash, Urticaria

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:
Current Illness:
Preexisting Conditions: Med allergy to Sulfa
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Broke out with rash and hives 4-7-07 x 3 days.


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