National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 270631

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

270631
VAERS Form:
Age:20.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-09
Submitted:2007-01-17
Entered:2007-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2609AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site warmth, Pain

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: HA, sinus pressure no temp
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:pt stated post last vaccine admin. arm was hot to touch and sore


Changed on 12/8/2009

270631 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-09
Submitted:2007-01-17
Entered:2007-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2609AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Injection site warmth, Pain

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: HA, sinus pressure no temp
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:pt stated post last vaccine admin. arm was hot to touch and sore


Changed on 5/14/2017

270631 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-09
Submitted:2007-01-17
Entered:2007-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2609AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site warmth, Pain

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: HA, sinus pressure no temp
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:pt stated post last vaccine admin. arm was hot to touch and sore


Changed on 9/14/2017

270631 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-09
Submitted:2007-01-17
Entered:2007-01-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2609AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site warmth, Pain

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: HA, sinus pressure no temp
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:pt stated post last vaccine admin. arm was hot to touch and sore


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=270631&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166