National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 276557

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276557
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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

276557 Before After
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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

276557 Before After
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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

276557 Before After
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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

276557 Before After
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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

276557 Before After
VAERS Form:
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
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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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 9/14/2017

276557 Before After
VAERS Form:(blank) 1
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 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1853BB / 0 1 RA / -

Administered by: Public      Purchased by: Public
Symptoms: Pityriasis rosea, 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: Ortho
Current Illness: none
Preexisting Conditions: none
Allergies:
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.


New Search

Link To This Search Result:

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


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166