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This is VAERS ID 270365

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270365
VAERS Form:
Age:14.0
Gender:Female
Location:New York
Vaccinated:2006-11-27
Onset:2006-11-28
Submitted:2007-01-10
Entered:2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09546 / 0 - / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1052F / 1 - / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Feeling hot, Tenderness

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

Write-up:Right deltoid erythematous, warm and tender.


Changed on 12/8/2009

270365 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
Vaccinated:2006-11-27
Onset:2006-11-28
Submitted:2007-01-10
Entered:2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09546 / 0 - / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1052F / 1 - / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Erythema, Feeling hot, Tenderness

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

Write-up:Right deltoid erythematous, warm and tender.


Changed on 4/7/2010

270365 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
Vaccinated:2006-11-27
Onset:2006-11-28
Submitted:2007-01-10
Entered:2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09546 / 0 - / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1052F / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Feeling hot, Tenderness

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

Write-up:Right deltoid erythematous, warm and tender.


Changed on 5/14/2017

270365 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:New York
Vaccinated:2006-11-27
Onset:2006-11-28
Submitted:2007-01-10
Entered:2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09546 / 0 - / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1932AB / 0 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1052F / 1 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Feeling hot, Tenderness

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

Write-up:Right deltoid erythematous, warm and tender.


Changed on 9/14/2017

270365 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:New York
Vaccinated:2006-11-27
Onset:2006-11-28
Submitted:2007-01-10
Entered:2007-01-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 1 - / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 09546 / 0 1 - / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1932AB / 0 1 - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1052F / 1 2 - / SC

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Feeling hot, Tenderness

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

Write-up:Right deltoid erythematous, warm and tender.


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