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This is VAERS ID 273640

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273640
VAERS Form:
Age:19.0
Gender:Female
Location:Maine
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-02-28
Entered:2007-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0889F / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Nausea, Pain, Pyrexia, Swelling

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:
Preexisting Conditions: NKDA-Eczema
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Right arm red, swollen, has fever, nausea, body aches, no rash or hives.


Changed on 4/7/2010

273640 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Maine
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-02-28
Entered:2007-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1932AB / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0889F / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Nausea, Pain, Pyrexia, Swelling

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:
Preexisting Conditions: NKDA-Eczema
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Right arm red, swollen, has fever, nausea, body aches, no rash or hives.


Changed on 5/14/2017

273640 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Maine
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-02-28
Entered:2007-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1932AB / - RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0889F / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Nausea, Pain, Pyrexia, Swelling

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:
Preexisting Conditions: NKDA-Eczema
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Right arm red, swollen, has fever, nausea, body aches, no rash or hives.


Changed on 9/14/2017

273640 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Maine
Vaccinated:2007-02-26
Onset:2007-02-26
Submitted:2007-02-28
Entered:2007-03-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / - UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1932AB / - UNK RA / IM
PPV: PNEUMO (PNEUMOVAX) / MERCK & CO. INC. 0889F / - UNK RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Nausea, Pain, Pyrexia, Swelling

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:
Preexisting Conditions: NKDA-Eczema
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Right arm red, swollen, has fever, nausea, body aches, no rash or hives.


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