| VAERS ID: | 365986 (history) | Vaccinated: | 2009-07-21 | | Age: | 12.0 | Onset: | 2009-09-04, Days after vaccination: 45 | | Gender: | Female | Submitted: | 2009-11-09, Days after onset: 66 | | Location: | Texas | Entered: | 2009-11-09 | |
| Life Threatening? No |
| Died? No |
| Permanent Disability? No |
| Recovered? Yes | | ER or Doctor Visit? No |
| Hospitalized? No | | Previous Vaccinations: | | Other Medications: The vaccine in Box 13 at top, above is suppose to be Gardasil but there is not an option to pick this vaccine. Manufacturer is Merck, lot 00874 and given on 7-21-09 | | Current Illness: No | | Preexisting Conditions: No | | Diagnostic Lab Data: | | CDC 'Split Type': | |