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This is VAERS ID 264209

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

264209
VAERS Form:
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-27
Onset:2006-09-27
Submitted:2006-10-02
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. B229AA / 0 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, INC. Y1067 / 1 LA / IM
MMRV: MEASLES, MUMPS, RUBELLA, AND VARICELLA (PROQUAD) / MERCK & CO. INC. 0816F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR, INC. AC52B002AA / 4 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Cellulitis, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Cellulitis at injection site


Changed on 12/8/2009

264209 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-27
Onset:2006-09-27
Submitted:2006-10-02
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. B229AA / 0 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR Y1067 / 1 LA / IM
MMRV: MEASLES, MUMPS, RUBELLA, AND VARICELLA (PROQUAD) MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0816F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR AC52B002AA / 4 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Cellulitis, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Cellulitis at injection site


Changed on 5/14/2017

264209 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-27
Onset:2006-09-27
Submitted:2006-10-02
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. B229AA / 0 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / AVENTIS PASTEUR SANOFI PASTEUR Y1067 / 1 LA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0816F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR AC52B002AA / 4 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cellulitis, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Cellulitis at injection site


Changed on 9/14/2017

264209 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Unknown
Vaccinated:2006-09-27
Onset:2006-09-27
Submitted:2006-10-02
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. B229AA / 0 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Y1067 / 1 2 LA / IM
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 0816F / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B002AA / 4 5 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Cellulitis, Injection site reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Cellulitis at injection site


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