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This is VAERS ID 276557

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276557
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2004-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


Changed on 12/8/2009

VAERS ID: 276557 Before After
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2004-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


Changed on 4/7/2010

VAERS ID: 276557 Before After
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2004-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


Changed on 10/5/2010

VAERS ID: 276557 Before After
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2004-03-22 2007-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


Changed on 6/14/2014

VAERS ID: 276557 Before After
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


Changed on 5/14/2017

VAERS ID: 276557 Before After
Age:16.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-03-22
Onset:2007-03-25
Submitted:2007-03-29
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1853BB / 0 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Pityriasis rosea, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Ortho
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines 3/22/07, developed hives on stomach and back 3/25/07. On 4-3-07 saw a dermatologist and was diagnosed with pityriasis rosea.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276557&WAYBACKHISTORY=ON


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