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This is VAERS ID 276013

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276013
VAERS Form:
Age:17.0
Gender:Female
Location:Oregon
Vaccinated:2007-03-13
Onset:2007-03-13
Submitted:2007-04-04
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Pyrexia, 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: Effexor XR 150 mg; Lexapro 10 mg; Ortho Evra Patch
Current Illness: None
Preexisting Conditions: Allergy Augmentin and Penicillin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Moderate Fever, widespread rash/hives


Changed on 12/8/2009

276013 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Oregon
Vaccinated:2007-03-13
Onset:2007-03-13
Submitted:2007-04-04
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Pyrexia, 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: Effexor XR 150 mg; Lexapro 10 mg; Ortho Evra Patch
Current Illness: None
Preexisting Conditions: Allergy Augmentin and Penicillin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Moderate Fever, widespread rash/hives


Changed on 9/14/2017

276013 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Oregon
Vaccinated:2007-03-13
Onset:2007-03-13
Submitted:2007-04-04
Entered:2007-04-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Pyrexia, 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: Effexor XR 150 mg; Lexapro 10 mg; Ortho Evra Patch
Current Illness: None
Preexisting Conditions: Allergy Augmentin and Penicillin
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Moderate Fever, widespread rash/hives


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