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This is VAERS ID 276177

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276177
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1968AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 1 RA / SC

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AMOXIL ALLERGY
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:area of erythema and induration at site of second varicella immunization. 9 by 4 cm. no fever


Changed on 12/8/2009

VAERS ID: 276177 Before After
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1968AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 1 RA / SC

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AMOXIL ALLERGY
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:area of erythema and induration at site of second varicella immunization. 9 by 4 cm. no fever


Changed on 4/7/2010

VAERS ID: 276177 Before After
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1968AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 1 RA / SC

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AMOXIL ALLERGY
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:area of erythema and induration at site of second varicella immunization. 9 by 4 cm. no fever


Changed on 5/14/2017

VAERS ID: 276177 Before After
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-04-10
Onset:2007-04-11
Submitted:2007-04-12
Entered:2007-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1968AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B011AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0113U / 1 RA / SC

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

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NONE
Preexisting Conditions: AMOXIL ALLERGY
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:area of erythema and induration at site of second varicella immunization. 9 by 4 cm. no fever


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