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This is VAERS ID 271456

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

271456
VAERS Form:
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-01-15
Onset:2007-01-17
Submitted:2007-01-29
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0694F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2638AA / 0 LA / IM

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

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

Write-up:Mild erythema and edema to Left deltoid. Prescribed over the counter Motrin 400 mg every 6-8 hours as needed.


Changed on 12/8/2009

271456 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-01-15
Onset:2007-01-17
Submitted:2007-01-29
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0694F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2638AA / 0 LA / IM

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

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

Write-up:Mild erythema and edema to Left deltoid. Prescribed over the counter Motrin 400 mg every 6-8 hours as needed.


Changed on 5/14/2017

271456 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-01-15
Onset:2007-01-17
Submitted:2007-01-29
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0694F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2638AA / 0 LA / IM

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

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

Write-up:Mild erythema and edema to Left deltoid. Prescribed over the counter Motrin 400 mg every 6-8 hours as needed.


Changed on 9/14/2017

271456 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Missouri
Vaccinated:2007-01-15
Onset:2007-01-17
Submitted:2007-01-29
Entered:2007-01-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0694F / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2638AA / 0 1 LA / IM

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

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

Write-up:Mild erythema and edema to Left deltoid. Prescribed over the counter Motrin 400 mg every 6-8 hours as needed.


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