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This is VAERS ID 277202

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277202
VAERS Form:
Age:11.0
Gender:Female
Location:Kansas
Vaccinated:2007-04-09
Onset:2007-04-10
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2610AA / 5 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Neck 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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Of reports sore, red, hot left upper arm, also pain on the left side of her neck, fatigue and body aches.


Changed on 12/8/2009

277202 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Kansas
Vaccinated:2007-04-09
Onset:2007-04-10
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2610AA / 5 LA / -

Administered by: Public      Purchased by: Unknown Private
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Neck pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Of reports sore, red, hot left upper arm, also pain on the left side of her neck, fatigue and body aches.


Changed on 5/14/2017

277202 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Kansas
Vaccinated:2007-04-09
Onset:2007-04-10
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / -
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2610AA / 5 LA / -

Administered by: Public      Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Neck pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Of reports sore, red, hot left upper arm, also pain on the left side of her neck, fatigue and body aches.


Changed on 9/14/2017

277202 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Kansas
Vaccinated:2007-04-09
Onset:2007-04-10
Submitted:2007-04-16
Entered:2007-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 1 RA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2610AA / 5 6 LA / -

Administered by: Public      Purchased by: Private
Symptoms: Fatigue, Injection site erythema, Injection site pain, Injection site warmth, Neck pain, 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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up:Of reports sore, red, hot left upper arm, also pain on the left side of her neck, fatigue and body aches.


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