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This is VAERS ID 266592

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

266592
VAERS Form:
Age:11.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-10-31
Onset:2006-11-01
Submitted:2006-11-06
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, INC. U2199AA / 4 RA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE AC52B011CA / 5 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Rash, Rash papular

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

Write-up:Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet.


Changed on 12/8/2009

266592 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-10-31
Onset:2006-11-01
Submitted:2006-11-06
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR U2199AA / 4 RA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE GLAXOSMITHKLINE BIOLOGICALS AC52B011CA / 5 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Erythema, Rash, Rash papular

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

Write-up:Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet.


Changed on 7/7/2013

266592 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-10-31
Onset:2006-11-01
Submitted:2006-11-06
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2199AA / 4 RA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2199AA / 4 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011CA / 5 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Rash, Rash papular

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

Write-up:Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet.


Changed on 5/14/2017

266592 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-10-31
Onset:2006-11-01
Submitted:2006-11-06
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR U2199AA / 4 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011CA / 5 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Rash, Rash papular, Rash pruritic

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

Write-up:Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet.


Changed on 9/14/2017

266592 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-10-31
Onset:2006-11-01
Submitted:2006-11-06
Entered:2006-11-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2199AA / 4 5 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011CA / 5 6 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Rash, Rash papular, Rash pruritic

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

Write-up:Fine red, papular, pruritic rash on 1st and 2nd digits both hands and dorsum both feet.


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