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This is VAERS ID 276976

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276976
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:2007-04-13
Onset:2007-04-16
Submitted:2007-04-16
Entered:2007-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1947AA / 0 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 0 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


Changed on 12/8/2009

276976 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:2007-04-13
Onset:2007-04-16
Submitted:2007-04-16
Entered:2007-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1947AA / 0 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 0 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


Changed on 4/7/2010

276976 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:2007-04-13
Onset:2007-04-16
Submitted:2007-04-16
Entered:2007-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U1947AA / 0 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 0 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


Changed on 5/14/2017

276976 Before After
VAERS Form:
Age:
Gender:Female
Location:North Carolina
Vaccinated:2007-04-13
Onset:2007-04-16
Submitted:2007-04-16
Entered:2007-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1947AA / 0 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 0 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


Changed on 9/14/2017

276976 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:North Carolina
Vaccinated:2007-04-13
Onset:2007-04-16
Submitted:2007-04-16
Entered:2007-04-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 0 1 RL / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B065CA / 0 1 LL / IM

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

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Lg, tender, erythematous area of approx 8x 11 cm with area of induration 6 x 7 cm, around site of Menactra vaccine. Tender area of eryth. and induration 3 x 6 cm of TDaP vaccine. Both vacc. given 3 days ago. Given Zyrtec 10 mg qd


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