National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 273099

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273099
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-02-23
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Chest discomfort, Cough, Dyspnoea, Hypersensitivity

Life Threatening? Yes
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC 'Split Type':

Write-up:None Stated


Changed on 12/8/2009

273099 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-02-23
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Chest discomfort, Cough, Dyspnoea, Hypersensitivity, Tremor, Wheezing

Life Threatening? Yes
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC 'Split Type':

Write-up:None Stated 03/05/07-records received from facility: seen in ED for allergic reaction to vaccines. HX of cough, wheezing and SOB few hours prior to ED visit, symptoms began 30 minutes after vaccines. Initially returned to PCP with c/o chest tightness, difficulty breathing, treated with epipen and benadryl and sent to ED. No swelling of mouth, lips or tongue. Allergies to cat (owns a cat). Uses nasonex for nasal congestion. VS P: 141, resp 20 BP 130/91. Treated with solu medol and ranitidine. Tremors, difficulty breathing. PE unremarkable. Lungs clear, no rhonchi, no wheezes. Admitted for IV steroid treatment.


Changed on 4/7/2010

273099 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-02-23
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chest discomfort, Cough, Dyspnoea, Hypersensitivity, Tremor, Wheezing

Life Threatening? Yes
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC 'Split Type':

Write-up:None Stated 03/05/07-records received from facility: seen in ED for allergic reaction to vaccines. HX of cough, wheezing and SOB few hours prior to ED visit, symptoms began 30 minutes after vaccines. Initially returned to PCP with c/o chest tightness, difficulty breathing, treated with epipen and benadryl and sent to ED. No swelling of mouth, lips or tongue. Allergies to cat (owns a cat). Uses nasonex for nasal congestion. VS P: 141, resp 20 BP 130/91. Treated with solu medol and ranitidine. Tremors, difficulty breathing. PE unremarkable. Lungs clear, no rhonchi, no wheezes. Admitted for IV steroid treatment.


Changed on 2/14/2017

273099 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-02-23
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Chest discomfort, Cough, Dyspnoea, Hypersensitivity, Tremor, Wheezing

Life Threatening? Yes
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC 'Split Type':

Write-up:None Stated 03/05/07-records received from facility: seen in ED for allergic reaction to vaccines. HX of cough, wheezing and SOB few hours prior to ED visit, symptoms began 30 minutes after vaccines. Initially returned to PCP with c/o chest tightness, difficulty breathing, treated with epipen and benadryl and sent to ED. No swelling of mouth, lips or tongue. Allergies to cat (owns a cat). Uses nasonex for nasal congestion. VS P: 141, resp 20 BP 130/91. Treated with solu medol and ranitidine. Tremors, difficulty breathing. PE unremarkable. Lungs clear, no rhonchi, no wheezes. Admitted for IV steroid treatment.


Changed on 9/14/2017

273099 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:New York
Vaccinated:2007-02-22
Onset:2007-02-22
Submitted:2007-02-23
Entered:2007-02-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB141AA / 0 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms:

Life Threatening? Yes
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? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data: records received 4/5/07-CBC:66 neutrophils. 24.6 lymphocytes.
CDC 'Split Type':

Write-up:None Stated 03/05/07-records received from facility: seen in ED for allergic reaction to vaccines. HX of cough, wheezing and SOB few hours prior to ED visit, symptoms began 30 minutes after vaccines. Initially returned to PCP with c/o chest tightness, difficulty breathing, treated with epipen and benadryl and sent to ED. No swelling of mouth, lips or tongue. Allergies to cat (owns a cat). Uses nasonex for nasal congestion. VS P: 141, resp 20 BP 130/91. Treated with solu medol and ranitidine. Tremors, difficulty breathing. PE unremarkable. Lungs clear, no rhonchi, no wheezes. Admitted for IV steroid treatment.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=273099&WAYBACKHISTORY=ON


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