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This is VAERS ID 275476

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 275476
VAERS Form:
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 0 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 LA / -
SMALL: SMALLPOX (DRYVAX) / WYETH PHARMACEUTICALS, INC 4020076 / 0 RA / -

Administered by: Military      Purchased by: Unknown
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.


Changed on 12/8/2009

VAERS ID: 275476 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 0 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 LA / -
SMALL: SMALLPOX (DRYVAX) / WYETH PHARMACEUTICALS, INC 4020076 / 0 RA / -

Administered by: Military      Purchased by: Unknown Military
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.


Changed on 8/31/2010

VAERS ID: 275476 Before After
VAERS Form:
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 0 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 LA / -
SMALL: SMALLPOX (DRYVAX) / WYETH PHARMACEUTICALS, INC PFIZER/WYETH 4020076 / 0 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.


Changed on 9/14/2017

VAERS ID: 275476 Before After
VAERS Form:(blank) 1
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 0 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 0 1 LA / -
SMALL: SMALLPOX (DRYVAX) / PFIZER/WYETH 4020076 / 0 1 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.


Changed on 2/14/2018

VAERS ID: 275476 Before After
VAERS Form:1
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / -
SMALL: SMALLPOX (DRYVAX) / PFIZER/WYETH 4020076 / 1 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.


Changed on 6/14/2018

VAERS ID: 275476 Before After
VAERS Form:1
Age:23.0
Gender:Female
Location:Mississippi
Vaccinated:2007-03-12
Onset:2007-03-23
Submitted:0000-00-00
Entered:2007-04-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
ANTH: ANTHRAX (BIOTHRAX) / EMERGENT BIOSOLUTIONS FAV103 / 1 LA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / -
SMALL: SMALLPOX (DRYVAX) / PFIZER/WYETH 4020076 / 1 RA / -

Administered by: Military      Purchased by: Military
Symptoms: Abdominal pain, Back pain, Pyrexia, Rash pruritic

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: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: 1-2 wk-fever, lower back pain, lower abdominal pain. 23-MAR-broke out in small red bumps that got bigger and itched really bad.

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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275476&WAYBACKHISTORY=ON


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