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This is VAERS ID 277700

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277700
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-03-29
Onset:0000-00-00
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Hypersensitivity, Rash papular, Allergy test, Allergy test positive

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: Prevacid, Qvar, Nasacort, Xopenex, Evocam topical
Current Illness:
Preexisting Conditions: Ehlers-Danlos Synd; Asthma, Allergy PCN, Keflex, Zithromax
Allergies:
Diagnostic Lab Data: pt had (+) tests to tree, dust, grass
CDC 'Split Type':

Write-up:shot #1 never seen by me. Saw dermatologist report enclosed /"papular urticaria vs. hypersensitivity. Shot #2 never seen by anyone. Mom (R.N.) reported hives forearms, trunk, buttocks


Changed on 12/8/2009

277700 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-03-29
Onset:0000-00-00
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / UN

Administered by: Private      Purchased by: Unknown Private
Symptoms: Hypersensitivity, Rash papular, Urticaria, Allergy test, Allergy test positive

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: Prevacid, Qvar, Nasacort, Xopenex, Evocam topical
Current Illness:
Preexisting Conditions: Ehlers-Danlos Synd; Asthma, Allergy PCN, Keflex, Zithromax
Allergies:
Diagnostic Lab Data: pt had (+) tests to tree, dust, grass
CDC 'Split Type':

Write-up:shot #1 never seen by me. Saw dermatologist report enclosed /"papular "papular urticaria vs. hypersensitivity. Shot #2 never seen by anyone. Mom (R.N.) reported hives forearms, trunk, buttocks


Changed on 9/14/2017

277700 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:New York
Vaccinated:2007-03-29
Onset:0000-00-00
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 2 LA / UN

Administered by: Private      Purchased by: Private
Symptoms: Hypersensitivity, Rash papular, Urticaria, Allergy test, Allergy test positive

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: Prevacid, Qvar, Nasacort, Xopenex, Evocam topical
Current Illness:
Preexisting Conditions: Ehlers-Danlos Synd; Asthma, Allergy PCN, Keflex, Zithromax
Allergies:
Diagnostic Lab Data: pt had (+) tests to tree, dust, grass
CDC 'Split Type':

Write-up:shot #1 never seen by me. Saw dermatologist report enclosed "papular urticaria vs. hypersensitivity. Shot #2 never seen by anyone. Mom (R.N.) reported hives forearms, trunk, buttocks


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