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History of Changes from the VAERS Wayback Machine |
VAERS ID: | 264556 |
VAERS Form: | |
Age: | 16.0 |
Sex: | Female |
Location: | Indiana |
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, INC. | U2239AA / 1 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 1 | LA / - |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. | 0955F / 0 | RA / - |
Administered by: Private Purchased by: Unknown
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR | U2239AA / 1 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 1 | LA / - |
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 0 | RA / - |
Administered by: Private Purchased by: Unknown Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR | U2239AA / 1 | LA / - |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR | U2239AA / 1 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 1 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 0 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR | U2239AA / 1 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 1 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 0 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 1 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 1 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 0 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Vaccinated: | 2006-10-05 |
Onset: | 2006-10-05 |
Submitted: | 2006-10-13 |
Entered: | 2006-10-16 |
Vaccination / Manufacturer | Lot / Dose | Site / Route |
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR | U2239AA / 2 | LA / - |
HEP: HEP B (RECOMBIVAX HB) / MERCK & CO. INC. | 0223F / 2 | LA / - |
HPV4: HPV (GARDASIL) / MERCK & CO. INC. | 0955F / 1 | RA / - |
Administered by: Private Purchased by: Private
Symptoms: Injection site pain
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:
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':
Write-up: Pain in right upper arm from time of administration of vaccine and continuing 8 days.
Link To This Search Result:
https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264556&WAYBACKHISTORY=ON
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