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This is VAERS ID 277390

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277390
VAERS Form:
Age:16.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-08
Onset:2007-01-09
Submitted:2007-04-25
Entered:2007-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR 121974AB / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B005CA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Eye swelling, Headache, Rash, Skin test positive, Allergy test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Hx of Asthma-been on Flonase, Claritin, Albuterol in past
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Allergy testing by Allergist (+) Skin test to Menactra
CDC 'Split Type':

Write-up:1 hr after visit eyes swollen, rash on both wrists, wheezing (Hx of Asthma), HA, took 2 ASA for HA and Benadryl. Also tightness in throat. Better with in 15 minutes of Benadryl. Pt was on no allergy meds at this time.


Changed on 12/8/2009

277390 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-08
Onset:2007-01-09
Submitted:2007-04-25
Entered:2007-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR 121974AB / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B005CA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Eye swelling, Headache, Rash, Skin test positive, Throat tightness, Wheezing, Allergy test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Hx of Asthma-been on Flonase, Claritin, Albuterol in past
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Allergy testing by Allergist (+) Skin test to Menactra
CDC 'Split Type':

Write-up:1 hr after visit eyes swollen, rash on both wrists, wheezing (Hx of Asthma), HA, took 2 ASA for HA and Benadryl. Also tightness in throat. Better with in 15 minutes of Benadryl. Pt was on no allergy meds at this time.


Changed on 4/7/2010

277390 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-08
Onset:2007-01-09
Submitted:2007-04-25
Entered:2007-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR 121974AB / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B005CA / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Eye swelling, Headache, Rash, Skin test positive, Throat tightness, Wheezing, Allergy test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Hx of Asthma-been on Flonase, Claritin, Albuterol in past
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Allergy testing by Allergist (+) Skin test to Menactra
CDC 'Split Type':

Write-up:1 hr after visit eyes swollen, rash on both wrists, wheezing (Hx of Asthma), HA, took 2 ASA for HA and Benadryl. Also tightness in throat. Better with in 15 minutes of Benadryl. Pt was on no allergy meds at this time.


Changed on 5/14/2017

277390 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-08
Onset:2007-01-09
Submitted:2007-04-25
Entered:2007-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR 121974AB / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B005CA / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Eye swelling, Headache, Rash, Skin test positive, Throat tightness, Wheezing, Allergy test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Hx of Asthma-been on Flonase, Claritin, Albuterol in past
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Allergy testing by Allergist (+) Skin test to Menactra
CDC 'Split Type':

Write-up:1 hr after visit eyes swollen, rash on both wrists, wheezing (Hx of Asthma), HA, took 2 ASA for HA and Benadryl. Also tightness in throat. Better with in 15 minutes of Benadryl. Pt was on no allergy meds at this time.


Changed on 9/14/2017

277390 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:North Carolina
Vaccinated:2007-01-08
Onset:2007-01-09
Submitted:2007-04-25
Entered:2007-04-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1209F / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 121974AB / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B005CA / 0 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Eye swelling, Headache, Rash, Skin test positive, Throat tightness, Wheezing, Allergy test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Hx of Asthma-been on Flonase, Claritin, Albuterol in past
Current Illness:
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: Allergy testing by Allergist (+) Skin test to Menactra
CDC 'Split Type':

Write-up:1 hr after visit eyes swollen, rash on both wrists, wheezing (Hx of Asthma), HA, took 2 ASA for HA and Benadryl. Also tightness in throat. Better with in 15 minutes of Benadryl. Pt was on no allergy meds at this time.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=277390&WAYBACKHISTORY=ON


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