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This is VAERS ID 278150

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278150
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-03-22
Onset:2007-04-07
Submitted:0000-00-00
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR UK2154CA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthralgia, Headache, Hypoaesthesia, Joint swelling, Antinuclear antibody positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: 4/20 ESR = 126, C3 = 216, ANA; Positive (1:20) (4/24) = 258, JGE = 601.00, C4 = 51
CDC 'Split Type':

Write-up:(1) Headache. (2) Numbness on arms and legs, (3) Joint swelling and pain (Elbows, wrist, (4) Hives and Macucopapular rash on arms and legs. Menactra verified.


Changed on 12/8/2009

278150 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-03-22
Onset:2007-04-07
Submitted:0000-00-00
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR UK2154CA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Arthralgia, Headache, Hypoaesthesia, Joint swelling, Rash maculo-papular, Urticaria, Red blood cell sedimentation rate increased, Antinuclear antibody positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: 4/20 ESR = 126, C3 = 216, ANA; Positive (1:20) (4/24) = 258, JGE = 601.00, C4 = 51
CDC 'Split Type':

Write-up:(1) Headache. (2) Numbness on arms and legs, (3) Joint swelling and pain (Elbows, wrist, (4) Hives and Macucopapular rash on arms and legs. Menactra verified.


Changed on 4/7/2010

278150 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-03-22
Onset:2007-04-07
Submitted:0000-00-00
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UK2154CA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Headache, Hypoaesthesia, Joint swelling, Rash maculo-papular, Urticaria, Red blood cell sedimentation rate increased, Antinuclear antibody positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: 4/20 ESR = 126, C3 = 216, ANA; Positive (1:20) (4/24) = 258, JGE = 601.00, C4 = 51
CDC 'Split Type':

Write-up:(1) Headache. (2) Numbness on arms and legs, (3) Joint swelling and pain (Elbows, wrist, (4) Hives and Macucopapular rash on arms and legs. Menactra verified.


Changed on 9/14/2017

278150 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:New York
Vaccinated:2007-03-22
Onset:2007-04-07
Submitted:0000-00-00
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UK2154CA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Headache, Hypoaesthesia, Joint swelling, Rash maculo-papular, Urticaria, Red blood cell sedimentation rate increased, Antinuclear antibody positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: 4/20 ESR = 126, C3 = 216, ANA; Positive (1:20) (4/24) = 258, JGE = 601.00, C4 = 51
CDC 'Split Type':

Write-up:(1) Headache. (2) Numbness on arms and legs, (3) Joint swelling and pain (Elbows, wrist, (4) Hives and Macucopapular rash on arms and legs. Menactra verified.


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