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This is VAERS ID 276336

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276336
VAERS Form:
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-03-12
Onset:2007-03-19
Submitted:2007-05-12
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / 1 - / SC

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

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Papular vesicular pruritic rash began 1 week after receiving Varivax booster.


Changed on 12/8/2009

276336 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-03-12
Onset:2007-03-19
Submitted:2007-05-12
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / 1 - / SC

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

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Papular vesicular pruritic rash began 1 week after receiving Varivax booster.


Changed on 9/14/2017

276336 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:New Jersey
Vaccinated:2007-03-12
Onset:2007-03-19
Submitted:2007-05-12
Entered:2007-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UNK - / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1497F / 1 2 - / SC

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

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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Papular vesicular pruritic rash began 1 week after receiving Varivax booster.


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