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This is VAERS ID 267432

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

267432
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06"the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 12/8/2009

267432 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (UNKNOWN MFR) INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': (blank) WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06"the 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 1/5/2010

267432 Before After
VAERS Form:
Age:12.0 13.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Other Private      Purchased by: Other Public
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 7/7/2013

267432 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / -

Administered by: Private      Purchased by: Public
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 3/14/2014

267432 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0800F / - UN / - UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / - UN

Administered by: Private      Purchased by: Public
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 12/14/2016

267432 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


Changed on 9/14/2017

267432 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:California
Vaccinated:2006-10-11
Onset:2006-10-11
Submitted:2006-11-14
Entered:2006-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0800F / - UNK UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. - / - UNK UN / UN

Administered by: Private      Purchased by: Public
Symptoms: Hypoaesthesia, Injection site reaction

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:
Current Illness:
Preexisting Conditions: Asthma, drug Hypersensitivity.
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type': WAES0610USA09277

Write-up:Information has been received from a physician concerning a 12 year old female with asthma and Advair allergy who on 10/11/06 was vaccinated with HVP vaccine. Concomitant therapy that day included varicella virus vaccine and influenza vaccine. On 10/11/06 the pt experienced numbing at injection site and around arm. The pt recovered. Unspecified medical attention was sought. Additional information has been requested.


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