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This is VAERS ID 276302

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276302
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-12
Onset:2007-04-12
Submitted:2007-04-13
Entered:2007-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / 0 RL / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Physical examination, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Temp 99 no other illnesses
Preexisting Conditions: none
Diagnostic Lab Data: physical exam 4/13/07 with flu scheduled
CDC 'Split Type':

Write-up:approx 1 hour after vaccine pt reported headache with temp (had tem 99 deg) per pt mom tem up to 102 approx 4 hour after I 25-vomiting approx 2 hour after I 25


Changed on 4/7/2010

VAERS ID: 276302 Before After
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-12
Onset:2007-04-12
Submitted:2007-04-13
Entered:2007-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / 0 RL / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Physical examination, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Temp 99 no other illnesses
Preexisting Conditions: none
Diagnostic Lab Data: physical exam 4/13/07 with flu scheduled
CDC 'Split Type':

Write-up:approx 1 hour after vaccine pt reported headache with temp (had tem 99 deg) per pt mom tem up to 102 approx 4 hour after I 25-vomiting approx 2 hour after I 25


Changed on 5/14/2017

VAERS ID: 276302 Before After
Age:11.0
Gender:Female
Location:California
Vaccinated:2007-04-12
Onset:2007-04-12
Submitted:2007-04-13
Entered:2007-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / 0 RL / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Physical examination, Vomiting

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Temp 99 no other illnesses
Preexisting Conditions: none
Diagnostic Lab Data: physical exam 4/13/07 with flu scheduled
CDC 'Split Type':

Write-up:approx 1 hour after vaccine pt reported headache with temp (had tem 99 deg) per pt mom tem up to 102 approx 4 hour after I 25-vomiting approx 2 hour after I 25


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276302&WAYBACKHISTORY=ON


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