National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 277199

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277199
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-13
Onset:2007-04-13
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2002AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine

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

Write-up:12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go /"bubbly/".


Changed on 12/8/2009

277199 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-13
Onset:2007-04-13
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2002AC / 0 LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine

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

Write-up:12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go /"bubbly/". "bubbly".


Changed on 4/7/2010

277199 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-13
Onset:2007-04-13
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2002AC / 0 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine

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

Write-up:12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go "bubbly".


Changed on 5/14/2017

277199 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-13
Onset:2007-04-13
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2002AC / 0 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine

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

Write-up:12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go "bubbly".


Changed on 9/14/2017

277199 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-04-13
Onset:2007-04-13
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2002AC / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Injection site erythema, Injection site induration, Injection site pruritus, Reaction to previous exposure to any vaccine

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

Write-up:12 cm x 9 cm, red , hard, itchy area, around inj site on left arm-Old imm site (from Age 3-given in Foreign country) swelled up and go "bubbly".


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=277199&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166