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This is VAERS ID 188549

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 188549
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECH 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Unknown
Symptoms: FEVER, ANOREXIA, EDEMA PERIPH, DEHYDRAT, ECCHYMOSIS

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash.


Changed on 12/8/2009

VAERS ID: 188549 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECH SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, AVENTIS PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Anorexia, Dehydration, Ecchymosis, Erythema, Malaise, Oedema peripheral, Pyrexia, FEVER, ANOREXIA, EDEMA PERIPH, DEHYDRAT, ECCHYMOSIS

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash.


Changed on 2/5/2010

VAERS ID: 188549 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR SANOFI PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Anorexia, Dehydration, Ecchymosis, Erythema, Malaise, Oedema peripheral, Pyrexia, 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 No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE ZANTAC
Current Illness: NONE Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 7/31/2010

VAERS ID: 188549 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 6/14/2014

VAERS ID: 188549 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 5/14/2017

VAERS ID: 188549 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 2 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 188549 Before After
VAERS Form:(blank) 1
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 2 3 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 2 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 0 1 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 188549 Before After
VAERS Form:1
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 3 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 1 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 188549 Before After
VAERS Form:1
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 3 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 1 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 188549 Before After
VAERS Form:1
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 3 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 1 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 188549 Before After
VAERS Form:1
Age:1.1
Gender:Female
Location:North Carolina
Vaccinated:2002-03-13
Onset:2002-03-20
Submitted:2002-03-22
Entered:2002-08-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEP: HEP B (ENGERIX-B) / SMITHKLINE BEECHAM 5272A2 / 3 - / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR T1310 / 3 - / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 0901L / 1 - / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain upper, Anorexia, Dehydration, Ecchymosis, Erythema, Irritability, Malaise, Oedema peripheral, Pyrexia, 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)? No
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZANTAC
Current Illness: Bottle feeding; Gastrosephageal reflux disease
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Seven days after immunization onset of edema and erythema of hands and feet that also turned into some ecchymosis, accompanied by fever, anorexia, decreased fluid intake, malaise, slight dehydration, mild skin rash. 02/11/2010 Follow-up information from the reporting physician indicated that the 20 week old female who on 12-DEC-2007 was vaccinated PO with her second dose of GARDASIL (lot# 657663/1461U). There was no illness at the time of vaccination. Concomitant drug therapy included ZANTAC 2.0 ml PO BID. On 13-DEC-2007 the patient experienced irritability, increased flarulence and colicky symptoms characterized by stomach pain and cramping and was taking less formula. No medical attention was sought. No labs of x-rays were performed. On approximately 20-DEC-2007 within 1 week., the patietn recovered. Additional information has been requested.

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