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This is VAERS ID 273813

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

273813
VAERS Form:
Age:14.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-02-20
Onset:2007-02-20
Submitted:2007-02-23
Entered:2007-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Incorrect dose administered

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: Adderall XR 20 mg daily ADD, Tetracycline 500 mg BID acne
Current Illness: ADD, Right ankle sprain, Acne
Preexisting Conditions: left elbow cracking
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Adult dose of Hepatitis A given (1440 elu) instead of pediatric dose of Hepatitis A (720 elu)


Changed on 12/8/2009

273813 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-02-20
Onset:2007-02-20
Submitted:2007-02-23
Entered:2007-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Incorrect dose administered

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: Adderall XR 20 mg daily ADD, Tetracycline 500 mg BID acne
Current Illness: ADD, Right ankle sprain, Acne
Preexisting Conditions: left elbow cracking
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Adult dose of Hepatitis A given (1440 elu) instead of pediatric dose of Hepatitis A (720 elu)


Changed on 9/14/2017

273813 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-02-20
Onset:2007-02-20
Submitted:2007-02-23
Entered:2007-03-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Incorrect dose administered

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: Adderall XR 20 mg daily ADD, Tetracycline 500 mg BID acne
Current Illness: ADD, Right ankle sprain, Acne
Preexisting Conditions: left elbow cracking
Allergies:
Diagnostic Lab Data: NONE
CDC 'Split Type':

Write-up:Adult dose of Hepatitis A given (1440 elu) instead of pediatric dose of Hepatitis A (720 elu)


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=273813&WAYBACKHISTORY=ON


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