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This is VAERS ID 276814

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276814
VAERS Form:
Age:
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up:Information has been received from a physician, via company representative, concerning a patient who was vaccinated with a dose, 0.5ml, IM, of Gardasil (date not specified). Subsequently the patient /"had a reaction to Gardasil./" The patient sought unspe"cified medical attention. Additional information has been requested.


Changed on 12/8/2009

276814 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0703USA03621

Write-up:Information has been received from a physician, via company representative, concerning a patient who was vaccinated with a dose, 0.5ml, IM, of Gardasil (date not specified). Subsequently the patient /"had "had a reaction to Gardasil./" Gardasil." The patient sought unspe"cified unspecified medical attention. Additional information has been requested.


Changed on 9/14/2017

276814 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-04-13
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM

Administered by: Other      Purchased by: Other
Symptoms: Unevaluable event

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0703USA03621

Write-up:Information has been received from a physician, via company representative, concerning a patient who was vaccinated with a dose, 0.5ml, IM, of Gardasil (date not specified). Subsequently the patient "had a reaction to Gardasil." The patient sought unspecified medical attention. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276814&WAYBACKHISTORY=ON


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