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This is VAERS ID 277458

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277458
VAERS Form:
Age:21.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-04-26
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2632AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Hypersensitivity, Nausea, Pruritus

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Orthotricyclen, Allegra D, Differin gel
Current Illness: none
Preexisting Conditions: Sulfa drugs
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient developed itching and rash on her chest which is a typical location for her when she has an allergic reaction. Also had dizziness, fatigue and nausea.


Changed on 12/8/2009

277458 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-04-26
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2632AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Dizziness, Fatigue, Hypersensitivity, Nausea, Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Orthotricyclen, Allegra D, Differin gel
Current Illness: none
Preexisting Conditions: Sulfa drugs
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient developed itching and rash on her chest which is a typical location for her when she has an allergic reaction. Also had dizziness, fatigue and nausea.


Changed on 5/14/2017

277458 Before After
VAERS Form:
Age:21.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-04-26
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2632AA / 0 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Dizziness, Fatigue, Hypersensitivity, Nausea, Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Orthotricyclen, Allegra D, Differin gel
Current Illness: none
Preexisting Conditions: Sulfa drugs
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient developed itching and rash on her chest which is a typical location for her when she has an allergic reaction. Also had dizziness, fatigue and nausea.


Changed on 9/14/2017

277458 Before After
VAERS Form:(blank) 1
Age:21.0
Gender:Female
Location:Missouri
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-04-26
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2632AA / 0 1 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Dizziness, Fatigue, Hypersensitivity, Nausea, Pruritus, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Orthotricyclen, Allegra D, Differin gel
Current Illness: none
Preexisting Conditions: Sulfa drugs
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient developed itching and rash on her chest which is a typical location for her when she has an allergic reaction. Also had dizziness, fatigue and nausea.


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