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This is VAERS ID 275819

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275819
VAERS Form:
Age:17.0
Gender:Female
Location:North Carolina
Vaccinated:2007-03-30
Onset:2007-04-01
Submitted:2007-04-02
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration

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: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:5cc of erythema/induration right u pper arm. Claritin, cool compresses.


Changed on 12/8/2009

275819 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:North Carolina
Vaccinated:2007-03-30
Onset:2007-04-01
Submitted:2007-04-02
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / 0 RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Injection site erythema, Injection site induration

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: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:5cc of erythema/induration right u pper arm. Claritin, cool compresses.


Changed on 4/7/2010

275819 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:North Carolina
Vaccinated:2007-03-30
Onset:2007-04-01
Submitted:2007-04-02
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR - / 0 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site induration

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: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:5cc of erythema/induration right u pper arm. Claritin, cool compresses.


Changed on 5/14/2017

275819 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:North Carolina
Vaccinated:2007-03-30
Onset:2007-04-01
Submitted:2007-04-02
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR - / 0 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site induration

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: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:5cc of erythema/induration right u pper arm. Claritin, cool compresses.


Changed on 9/14/2017

275819 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:North Carolina
Vaccinated:2007-03-30
Onset:2007-04-01
Submitted:2007-04-02
Entered:2007-04-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1213F / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / 0 1 RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site induration

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: obesity
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:5cc of erythema/induration right u pper arm. Claritin, cool compresses.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=275819&WAYBACKHISTORY=ON


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