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This is VAERS ID 274461

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274461
VAERS Form:
Age:19.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-11
Submitted:2007-03-14
Entered:2007-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2557AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Rash papular, Rash pruritic

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Itchy rash on both deltoids started 2 days after immunizations received. Rash is fine and papular.


Changed on 12/8/2009

274461 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-11
Submitted:2007-03-14
Entered:2007-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2557AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Rash papular, Rash pruritic

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Itchy rash on both deltoids started 2 days after immunizations received. Rash is fine and papular.


Changed on 4/7/2010

274461 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-11
Submitted:2007-03-14
Entered:2007-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1932AB / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2557AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash papular, Rash pruritic

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Itchy rash on both deltoids started 2 days after immunizations received. Rash is fine and papular.


Changed on 5/14/2017

274461 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-11
Submitted:2007-03-14
Entered:2007-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1932AB / 0 LA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2557AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash papular, Rash pruritic

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Itchy rash on both deltoids started 2 days after immunizations received. Rash is fine and papular.


Changed on 9/14/2017

274461 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:California
Vaccinated:2006-11-09
Onset:2006-11-11
Submitted:2007-03-14
Entered:2007-03-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1932AB / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2557AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Rash papular, Rash pruritic

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Itchy rash on both deltoids started 2 days after immunizations received. Rash is fine and papular.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=274461&WAYBACKHISTORY=ON


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