National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 278026

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278026
VAERS Form:
Age:11.0
Gender:Female
Location:Texas
Vaccinated:2007-02-15
Onset:2007-04-05
Submitted:2007-04-30
Entered:2007-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / SANOFI PASTEUR - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1922A / - UN / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631A / - UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Hives, cluster of 2 patients (patient identification provided) with generalized hives throughout the entire body, after receiving Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB), received from a health care pro"fessional in the USA on 24 April 2007. Case 1: An 11 year old, female patient ( with a history of no known allergies) developed generalized hives throughout the entire body, 1.1/2 months after she received Adacel (lot number C2631AA); Fluzone (lot number


Changed on 12/8/2009

278026 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Texas
Vaccinated:2007-02-15
Onset:2007-04-05
Submitted:2007-04-30
Entered:2007-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1922A / - UN / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631A / - UN / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': (blank) 200701400

Write-up:Hives, cluster of 2 patients (patient identification provided) with generalized hives throughout the entire body, after receiving Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB), received from a health care pro"fessional professional in the USA on 24 April 2007. Case 1: An 11 year old, female patient ( with a history of no known allergies) developed generalized hives throughout the entire body, 1.1/2 months after she received Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB) and Gardasil (Merck, lot number 0014U ) on the 15 February 2007. She has the Fluzone vaccine annually. The patient denies any illness or medications at the time of the vaccinations. She was treated with Cortisone, Singulair and Atarax. It was reported the hives resolved and the patient recovered. The second case (the patient ''s brother ) is detailed in case 2007-01399.


Changed on 4/7/2010

278026 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Texas
Vaccinated:2007-02-15
Onset:2007-04-05
Submitted:2007-04-30
Entered:2007-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922A / - UN / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631A / - UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200701400

Write-up:Hives, cluster of 2 patients (patient identification provided) with generalized hives throughout the entire body, after receiving Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB), received from a health care professional in the USA on 24 April 2007. Case 1: An 11 year old, female patient ( with a history of no known allergies) developed generalized hives throughout the entire body, 1.1/2 months after she received Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB) and Gardasil (Merck, lot number 0014U ) on the 15 February 2007. She has the Fluzone vaccine annually. The patient denies any illness or medications at the time of the vaccinations. She was treated with Cortisone, Singulair and Atarax. It was reported the hives resolved and the patient recovered. The second case (the patient ''s brother ) is detailed in case 2007-01399.


Changed on 7/7/2013

278026 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Texas
Vaccinated:2007-02-15
Onset:2007-04-05
Submitted:2007-04-30
Entered:2007-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / - UN / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922A / - UN / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631A / - UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200701400

Write-up:Hives, cluster of 2 patients (patient identification provided) with generalized hives throughout the entire body, after receiving Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB), received from a health care professional in the USA on 24 April 2007. Case 1: An 11 year old, female patient ( with a history of no known allergies) developed generalized hives throughout the entire body, 1.1/2 months after she received Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB) and Gardasil (Merck, lot number 0014U ) on the 15 February 2007. She has the Fluzone vaccine annually. The patient denies any illness or medications at the time of the vaccinations. She was treated with Cortisone, Singulair and Atarax. It was reported the hives resolved and the patient recovered. The second case (the patient ''s brother ) is detailed in case 2007-01399.


Changed on 9/14/2017

278026 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Texas
Vaccinated:2007-02-15
Onset:2007-04-05
Submitted:2007-04-30
Entered:2007-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR - / - UNK UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / - UNK UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922A / - UNK UN / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2631A / - UNK UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Urticaria

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:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type': 200701400

Write-up:Hives, cluster of 2 patients (patient identification provided) with generalized hives throughout the entire body, after receiving Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB), received from a health care professional in the USA on 24 April 2007. Case 1: An 11 year old, female patient ( with a history of no known allergies) developed generalized hives throughout the entire body, 1.1/2 months after she received Adacel (lot number C2631AA); Fluzone (lot number unknown), and Menactra (lot number U1922AB) and Gardasil (Merck, lot number 0014U ) on the 15 February 2007. She has the Fluzone vaccine annually. The patient denies any illness or medications at the time of the vaccinations. She was treated with Cortisone, Singulair and Atarax. It was reported the hives resolved and the patient recovered. The second case (the patient ''s brother ) is detailed in case 2007-01399.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=278026&WAYBACKHISTORY=ON


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