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This is VAERS ID 270433

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 270433
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-01-05
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR U2271AA / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2116AA / - LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site warmth, Skin ulcer, Tenderness

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

Write-up:Left Deltoid 5cm x 3 1/2 cm circular erythematous tender and warm to touch lesion arm very tender.


Changed on 12/8/2009

VAERS ID: 270433 Before After
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-01-05
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2271AA / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2116AA / - LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site warmth, Skin ulcer, Tenderness

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

Write-up:Left Deltoid 5cm x 3 1/2 cm circular erythematous tender and warm to touch lesion arm very tender.


Changed on 4/7/2010

VAERS ID: 270433 Before After
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-01-05
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2271AA / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2116AA / - LA / -

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth, Skin ulcer, Tenderness

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

Write-up:Left Deltoid 5cm x 3 1/2 cm circular erythematous tender and warm to touch lesion arm very tender.


Changed on 7/7/2013

VAERS ID: 270433 Before After
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-01-05
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2271AA / - LA / -
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2271AA / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2116AA / - LA / -

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth, Skin ulcer, Tenderness

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

Write-up:Left Deltoid 5cm x 3 1/2 cm circular erythematous tender and warm to touch lesion arm very tender.


Changed on 5/14/2017

VAERS ID: 270433 Before After
Age:17.0
Gender:Female
Location:New York
Vaccinated:2007-01-03
Onset:2007-01-03
Submitted:2007-01-05
Entered:2007-01-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR U2271AA / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / - RA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2116AA / - LA / -

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site warmth, Skin ulcer, Tenderness

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

Write-up:Left Deltoid 5cm x 3 1/2 cm circular erythematous tender and warm to touch lesion arm very tender.


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