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This is VAERS ID 271014

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 271014
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2082AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 12/8/2009

VAERS ID: 271014 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2082AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 1 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 4/7/2010

VAERS ID: 271014 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2082AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 5/14/2017

VAERS ID: 271014 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2082AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 9/14/2017

VAERS ID: 271014 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / - UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / - UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 1 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 2/14/2018

VAERS ID: 271014 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.


Changed on 6/14/2018

VAERS ID: 271014 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-01-16
Onset:2007-01-17
Submitted:2007-01-18
Entered:2007-01-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1154F / 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Injection site erythema, Injection site oedema, Injection site pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Pain, redness, swelling on (L) upper arm, feels weak no fever.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=271014&WAYBACKHISTORY=ON


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