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This is VAERS ID 277698

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 277698
VAERS Form:
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 0 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1947AA / 0 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 0 RA / UN

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

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: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


Changed on 12/8/2009

VAERS ID: 277698 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 0 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1947AA / 0 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 0 RA / UN

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

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': (blank) NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


Changed on 4/7/2010

VAERS ID: 277698 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 0 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 0 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 0 RA / UN

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

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': NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


Changed on 9/14/2017

VAERS ID: 277698 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 0 1 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 0 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 0 1 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 0 1 RA / UN

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

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': NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


Changed on 2/14/2018

VAERS ID: 277698 Before After
VAERS Form:1
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 1 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 1 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 1 RA / UN

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

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': NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07


Changed on 6/14/2018

VAERS ID: 277698 Before After
VAERS Form:1
Age:18.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-20
Onset:2007-04-23
Submitted:2007-04-25
Entered:2007-05-01
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER 1282E / 1 LA / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 03844 / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1947AA / 1 RA / UN
TDAP: TDAP (ADACEL) / SANOFI PASTEUR AC52B005CA / 1 RA / UN

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

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': NC07038

Write-up: 8 cm x 8 cm area of eryth and induration Tdap 4-20-07

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