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This is VAERS ID 273430

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273430
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-01
Onset:2007-03-02
Submitted:2007-03-05
Entered:2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1860AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2340AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Chills, Headache, Injection site pain, Musculoskeletal stiffness, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC 'Split Type':

Write-up:Patient awakened early 3/2/07 with fever, chills, nausea and headache. L arm at injection site was tender and puffy. Temperatures ranged from 100.8 to 102.0 throughout the day. 3/3/07-c/o nausea, headache and temp of 100.0 3/4/07- c/o headache and s"tiff neck. 3/5/07-c/o headache


Changed on 12/8/2009

273430 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-01
Onset:2007-03-02
Submitted:2007-03-05
Entered:2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1860AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2340AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Chills, Headache, Injection site pain, Nausea, Pyrexia, Musculoskeletal stiffness, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC 'Split Type':

Write-up:Patient awakened early 3/2/07 with fever, chills, nausea and headache. L arm at injection site was tender and puffy. Temperatures ranged from 100.8 to 102.0 throughout the day. 3/3/07-c/o nausea, headache and temp of 100.0 3/4/07- c/o headache and s"tiff stiff neck. 3/5/07-c/o headache


Changed on 4/7/2010

273430 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-01
Onset:2007-03-02
Submitted:2007-03-05
Entered:2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1860AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2340AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Chills, Headache, Injection site pain, Nausea, Pyrexia, Musculoskeletal stiffness, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC 'Split Type':

Write-up:Patient awakened early 3/2/07 with fever, chills, nausea and headache. L arm at injection site was tender and puffy. Temperatures ranged from 100.8 to 102.0 throughout the day. 3/3/07-c/o nausea, headache and temp of 100.0 3/4/07- c/o headache and stiff neck. 3/5/07-c/o headache


Changed on 5/14/2017

273430 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-01
Onset:2007-03-02
Submitted:2007-03-05
Entered:2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1860AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2340AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Chills, Headache, Injection site pain, Nausea, Pyrexia, Musculoskeletal stiffness, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC 'Split Type':

Write-up:Patient awakened early 3/2/07 with fever, chills, nausea and headache. L arm at injection site was tender and puffy. Temperatures ranged from 100.8 to 102.0 throughout the day. 3/3/07-c/o nausea, headache and temp of 100.0 3/4/07- c/o headache and stiff neck. 3/5/07-c/o headache


Changed on 9/14/2017

273430 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-03-01
Onset:2007-03-02
Submitted:2007-03-05
Entered:2007-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1860AA / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2340AA / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Chills, Headache, Injection site pain, Nausea, Pyrexia, Musculoskeletal stiffness, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
CDC 'Split Type':

Write-up:Patient awakened early 3/2/07 with fever, chills, nausea and headache. L arm at injection site was tender and puffy. Temperatures ranged from 100.8 to 102.0 throughout the day. 3/3/07-c/o nausea, headache and temp of 100.0 3/4/07- c/o headache and stiff neck. 3/5/07-c/o headache


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