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This is VAERS ID 272384

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 272384
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 1 LA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC


Changed on 12/8/2009

VAERS ID: 272384 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / - LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 1 LA / -

Administered by: Private      Purchased by: Unknown Other
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC


Changed on 9/14/2017

VAERS ID: 272384 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / - UNK LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 1 2 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 1 2 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC


Changed on 2/14/2018

VAERS ID: 272384 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / UNK LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 2 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 2 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC


Changed on 6/14/2018

VAERS ID: 272384 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / UNK LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 2 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 2 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC


Changed on 8/14/2018

VAERS ID: 272384 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-01-03
Onset:2007-01-05
Submitted:2007-01-05
Entered:2007-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0651F / UNK LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 2 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1140F / 2 LA / -

Administered by: Private      Purchased by: Other
Symptoms: Erythema, Induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Left upper, outer arm, 4 cm induration with erythema. Benadryl, Motrin RTC

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