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This is VAERS ID 272911

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

272911
VAERS Form:
Age:1.1
Gender:Female
Location:New York
Vaccinated:2007-02-17
Onset:2007-02-17
Submitted:2007-02-22
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 1 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1948AA / 1 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: No adverse effect, Wrong drug administered

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

Write-up:none-realized Dtap was given instead of Tdap


Changed on 12/8/2009

272911 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:New York
Vaccinated:2007-02-17
Onset:2007-02-17
Submitted:2007-02-22
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 1 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1948AA / 1 RA / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: No adverse effect, Wrong drug administered

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

Write-up:none-realized Dtap was given instead of Tdap


Changed on 4/7/2010

272911 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:New York
Vaccinated:2007-02-17
Onset:2007-02-17
Submitted:2007-02-22
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 1 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1948AA / 1 RA / -

Administered by: Private      Purchased by: Public
Symptoms: No adverse effect, Wrong drug administered

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

Write-up:none-realized Dtap was given instead of Tdap


Changed on 2/14/2017

272911 Before After
VAERS Form:
Age:1.1
Gender:Female
Location:New York
Vaccinated:2007-02-17
Onset:2007-02-17
Submitted:2007-02-22
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 1 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1948AA / 1 RA / -

Administered by: Private      Purchased by: Public
Symptoms: No adverse effect, Wrong drug administered

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

Write-up:none-realized Dtap was given instead of Tdap


Changed on 9/14/2017

272911 Before After
VAERS Form:(blank) 1
Age:1.1
Gender:Female
Location:New York
Vaccinated:2007-02-17
Onset:2007-02-17
Submitted:2007-02-22
Entered:2007-02-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS AC14B008AA / 1 2 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1447F / 1 2 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1948AA / 1 2 RA / -

Administered by: Private      Purchased by: Public
Symptoms: No adverse effect, Wrong drug administered

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

Write-up:none-realized Dtap was given instead of Tdap


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=272911&WAYBACKHISTORY=ON


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