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This is VAERS ID 265338

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 265338
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, INC. V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO, 7-VALENT (PREVNAR) / LEDERLE LABORATORIES B22930D / 3 LL / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Unevaluable event

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 12/8/2009

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, INC. SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) HEP A (HAVRIX) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO, 7-VALENT (PREVNAR) PNEUMO (PREVNAR) / LEDERLE LABORATORIES WYETH PHARMACEUTICALS, INC B22930D / 3 LL / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Wrong drug administered, Unevaluable event

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 3/2/2010

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) PNEUMO (PREVNAR7) / WYETH PHARMACEUTICALS, INC B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 4/7/2010

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR7) PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 8/31/2010

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 1/4/2011

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 4/13/2011

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 5/13/2011

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 6/11/2011

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 7/7/2013

VAERS ID: 265338 Before After
Age:1.0
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


Changed on 2/14/2017

VAERS ID: 265338 Before After
Age:1.0 1.03
Gender:Male
Location:Michigan
Vaccinated:2006-10-13
Onset:0000-00-00
Submitted:2006-10-17
Entered:2006-10-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR V2175HA / 0 UN / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB099CB / 0 UN / IM
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. 0212R / 3 UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 UN / IM
PNC: PNEUMO (PREVNAR) / PFIZER/WYETH B22930D / 3 LL / IM

Administered by: Private      Purchased by: Public
Symptoms: Wrong drug administered

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None Stated


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=265338&WAYBACKHISTORY=ON


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