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This is VAERS ID 276624

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276624
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2082AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 1 LA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


Changed on 12/8/2009

VAERS ID: 276624 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2082AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 1 LA / SC

Administered by: Public      Purchased by: Unknown Private
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


Changed on 4/7/2010

VAERS ID: 276624 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2082AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 1 LA / SC

Administered by: Public      Purchased by: Private
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


Changed on 5/14/2017

VAERS ID: 276624 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2082AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 1 LA / SC

Administered by: Public      Purchased by: Private
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


Changed on 9/14/2017

VAERS ID: 276624 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 1 2 LA / SC

Administered by: Public      Purchased by: Private
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


Changed on 2/14/2018

VAERS ID: 276624 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-03-06
Onset:2007-03-06
Submitted:2007-04-17
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1085F / 2 LA / SC

Administered by: Public      Purchased by: Private
Symptoms: Hypoaesthesia, Malaise, Nausea, Pain in extremity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: ZOPENEX
Current Illness: None
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up: Pain and numbeness in arm for 2 days after vaccine administered. Malaise and intermittant nausea since day of vaccination.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=276624&WAYBACKHISTORY=ON


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