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This is VAERS ID 281668

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281668
VAERS Form:
Age:20.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-06
Onset:2007-06-08
Submitted:2007-06-08
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 2 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2610AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Urticaria, Vaccine positive rechallenge

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: hives~HPV (Gardasil)~1~19~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Developed generalized hives this AM (6/8/07) Rx with Benadryl, per mom - same thing occurred 1 wk after HPV #1 and HPV #2


Changed on 12/8/2009

281668 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-06
Onset:2007-06-08
Submitted:2007-06-08
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 2 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2610AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Urticaria, Vaccine positive rechallenge

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: hives~HPV (Gardasil)~1~19~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Developed generalized hives this AM (6/8/07) Rx with Benadryl, per mom - same thing occurred 1 wk after HPV #1 and HPV #2


Changed on 5/14/2017

281668 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-06
Onset:2007-06-08
Submitted:2007-06-08
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 2 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2610AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria, Vaccine positive rechallenge

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: hives~HPV (Gardasil)~1~19~In (Gardasil)~1~19.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Developed generalized hives this AM (6/8/07) Rx with Benadryl, per mom - same thing occurred 1 wk after HPV #1 and HPV #2


Changed on 9/14/2017

281668 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-06
Onset:2007-06-08
Submitted:2007-06-08
Entered:2007-06-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 2 3 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2610AA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria, Vaccine positive rechallenge

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: hives~HPV (Gardasil)~1~19.00~In Patient
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Developed generalized hives this AM (6/8/07) Rx with Benadryl, per mom - same thing occurred 1 wk after HPV #1 and HPV #2


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