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This is VAERS ID 276797

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 276797
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-04-18
Entered:2007-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2002AC / - UN / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blister, Blood culture negative, Dehydration, Chapped lips, Fluid replacement

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: lip culture and blood cultures.
CDC 'Split Type':

Write-up:pt. received TDAP,HPV,VZV and MENING on 3/7/07. Within a week, one of the injections sites swelled,became painful and red. The doctor''''s office was notified of this reaction. Within two weeks of injections, both lips swelled for one day. Within 4 weeks of"injection, lips cracked and by the fith week after injection pt was hospitalized for severe stomatitis. Please note, the pt has never suffered these symptoms before, nor has she seeked care for this problem prior to this outbreak. Pt became dehydrated and


Changed on 12/8/2009

VAERS ID: 276797 Before After
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-04-18
Entered:2007-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2002AC / - UN / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blister, Blood culture negative, Dehydration, Herpes simplex, Injection site erythema, Injection site pain, Lip swelling, Stomatitis, Chapped lips, Injection site swelling, Fluid replacement

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: lip culture and blood cultures.
CDC 'Split Type':

Write-up:pt. received TDAP,HPV,VZV and MENING on 3/7/07. Within a week, one of the injections sites swelled,became painful and red. The doctor''''s doctor''s office was notified of this reaction. Within two weeks of injections, both lips swelled for one day. Within 4 weeks of"injection, of injection, lips cracked and by the fith week after injection pt was hospitalized for severe stomatitis. Please note, the pt has never suffered these symptoms before, nor has she seeked care for this problem prior to this outbreak. Pt became dehydrated and needed i.v. care. Pt had blister type lesions that started on the outside of the lips and continued to spread to the back of the throat. Pt has improved greatly and should have a full recovery. 6/27/07-records received from facility. Oral lesion, virus culture positive for herpes simplex virus. Blood culture no growth. No documentation to support hospitalization. Stomatitis outhreahs regularly meds needed daily, possibly for life. Altered life illness. The doctor wants her to get the other two shots. I think that is negligent! This shot never should have been given with all the others!


Changed on 4/7/2010

VAERS ID: 276797 Before After
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-04-18
Entered:2007-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / - UN / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blister, Blood culture negative, Dehydration, Herpes simplex, Injection site erythema, Injection site pain, Lip swelling, Stomatitis, Chapped lips, Injection site swelling, Fluid replacement

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: lip culture and blood cultures.
CDC 'Split Type':

Write-up:pt. received TDAP,HPV,VZV and MENING on 3/7/07. Within a week, one of the injections sites swelled,became painful and red. The doctor''s office was notified of this reaction. Within two weeks of injections, both lips swelled for one day. Within 4 weeks of injection, lips cracked and by the fith week after injection pt was hospitalized for severe stomatitis. Please note, the pt has never suffered these symptoms before, nor has she seeked care for this problem prior to this outbreak. Pt became dehydrated and needed i.v. care. Pt had blister type lesions that started on the outside of the lips and continued to spread to the back of the throat. Pt has improved greatly and should have a full recovery. 6/27/07-records received from facility. Oral lesion, virus culture positive for herpes simplex virus. Blood culture no growth. No documentation to support hospitalization. Stomatitis outhreahs regularly meds needed daily, possibly for life. Altered life illness. The doctor wants her to get the other two shots. I think that is negligent! This shot never should have been given with all the others!


Changed on 5/14/2017

VAERS ID: 276797 Before After
Age:16.0
Gender:Female
Location:California
Vaccinated:2007-03-07
Onset:2007-03-11
Submitted:2007-04-18
Entered:2007-04-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / - UN / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM
VARCEL: VARICELLA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blister, Blood culture negative, Dehydration, Herpes simplex, Injection site erythema, Injection site pain, Lip swelling, Stomatitis, Chapped lips, Injection site swelling, Fluid replacement

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data: lip culture and blood cultures.
CDC 'Split Type':

Write-up:pt. received TDAP,HPV,VZV and MENING on 3/7/07. Within a week, one of the injections sites swelled,became painful and red. The doctor''s office was notified of this reaction. Within two weeks of injections, both lips swelled for one day. Within 4 weeks of injection, lips cracked and by the fith week after injection pt was hospitalized for severe stomatitis. Please note, the pt has never suffered these symptoms before, nor has she seeked care for this problem prior to this outbreak. Pt became dehydrated and needed i.v. care. Pt had blister type lesions that started on the outside of the lips and continued to spread to the back of the throat. Pt has improved greatly and should have a full recovery. 6/27/07-records received from facility. Oral lesion, virus culture positive for herpes simplex virus. Blood culture no growth. No documentation to support hospitalization. Stomatitis outhreahs regularly meds needed daily, possibly for life. Altered life illness. The doctor wants her to get the other two shots. I think that is negligent! This shot never should have been given with all the others!


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