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This is VAERS ID 273740

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273740
VAERS Form:
Age:11.0
Gender:Female
Location:Colorado
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-07
Entered:2007-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BK / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1062F / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Erythema, Injection site vesicles, Oedema peripheral, Pain in extremity, Skin warm

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:Right upper arm red, hot, swollen 18 cm x 18 cm the circumference of arm. 5 small fluid filled vesicles around injection site. Patient c/o pain in effected arm. No systemic s/s. Doctor name reported examined patient and recommended Advil for pain ice to e"ffected area. Advised to go to E.R. if symptoms worsened or systemic involvement occurs and contact PCP.


Changed on 12/8/2009

273740 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Colorado
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-07
Entered:2007-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BK / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1062F / 1 RA / SC

Administered by: Public      Purchased by: Unknown Public
Symptoms: Erythema, Injection site vesicles, Oedema peripheral, Pain in extremity, Skin warm

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:Right upper arm red, hot, swollen 18 cm x 18 cm the circumference of arm. 5 small fluid filled vesicles around injection site. Patient c/o pain in effected arm. No systemic s/s. Doctor name reported examined patient and recommended Advil for pain ice to e"ffected effected area. Advised to go to E.R. if symptoms worsened or systemic involvement occurs and contact PCP.


Changed on 9/14/2017

273740 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Colorado
Vaccinated:2007-03-05
Onset:2007-03-05
Submitted:2007-03-07
Entered:2007-03-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BK / 0 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1062F / 1 2 RA / SC

Administered by: Public      Purchased by: Public
Symptoms: Erythema, Injection site vesicles, Oedema peripheral, Pain in extremity, Skin warm

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:Right upper arm red, hot, swollen 18 cm x 18 cm the circumference of arm. 5 small fluid filled vesicles around injection site. Patient c/o pain in effected arm. No systemic s/s. Doctor name reported examined patient and recommended Advil for pain ice to effected area. Advised to go to E.R. if symptoms worsened or systemic involvement occurs and contact PCP.


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