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This is VAERS ID 278026

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 278026
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
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

VAERS ID: 278026 Before After
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
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

VAERS ID: 278026 Before After
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
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

VAERS ID: 278026 Before After
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
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: History of no known allergies. She has the Fluzone vaccine annually.
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.


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