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This is VAERS ID 277413

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

277413
VAERS Form:
Age:
Gender:Unknown
Location:Missouri
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2208AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C26900AA / 5 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Dyspnoea, Rash, Wheezing

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Anaphylaxis, rash, wheezing, mild difficulty breathing. Recovered completely with steroids, Benadryl, etc. Has since had second Gardasil, no problems.


Changed on 4/7/2010

277413 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Missouri
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2208AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C26900AA / 5 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Dyspnoea, Rash, Wheezing

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Anaphylaxis, rash, wheezing, mild difficulty breathing. Recovered completely with steroids, Benadryl, etc. Has since had second Gardasil, no problems.


Changed on 5/14/2017

277413 Before After
VAERS Form:
Age:
Gender:Unknown
Location:Missouri
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2208AA / 0 RA / IM
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C26900AA / 5 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Dyspnoea, Rash, Wheezing

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Anaphylaxis, rash, wheezing, mild difficulty breathing. Recovered completely with steroids, Benadryl, etc. Has since had second Gardasil, no problems.


Changed on 9/14/2017

277413 Before After
VAERS Form:(blank) 1
Age:
Gender:Unknown
Location:Missouri
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:0000-00-00
Entered:2007-04-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2208AA / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C26900AA / 5 6 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / 1 2 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Anaphylactic reaction, Dyspnoea, Rash, Wheezing

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Anaphylaxis, rash, wheezing, mild difficulty breathing. Recovered completely with steroids, Benadryl, etc. Has since had second Gardasil, no problems.


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