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This is VAERS ID 278152

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 278152
Age:12.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-05-04
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Heart rate, Heart rate normal, Rash pruritic, Respiratory rate increased

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg 11:00am, Benadryl 50mg 1:12 pm
Current Illness: None known
Preexisting Conditions: allergy testing and injection (weekly) Tree, grass, and + allergy injection
Diagnostic Lab Data: Temp 97.5, BP 102/58, AHR 90 Resp. 24 Schedule for allergy tests with allergist in approximately one month
CDC 'Split Type':

Write-up:Student came to Student Health Center at 105 pm complaining of a pruritic rash on arms, back stomach and neck - denies any additional symptoms of concern. Have appt. today already scheduled with allergist Dr. Cypcor (state first noted itching at about 11:"45 am) rash eased within 15 minutes of Benadryl.


Changed on 12/8/2009

VAERS ID: 278152 Before After
Age:12.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-05-04
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AA / 0 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Heart rate, Heart rate normal, Rash pruritic, Respiratory rate increased

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg 11:00am, Benadryl 50mg 1:12 pm
Current Illness: None known
Preexisting Conditions: allergy testing and injection (weekly) Tree, grass, and + allergy injection
Diagnostic Lab Data: Temp 97.5, BP 102/58, AHR 90 Resp. 24 Schedule for allergy tests with allergist in approximately one month
CDC 'Split Type':

Write-up:Student came to Student Health Center at 105 pm complaining of a pruritic rash on arms, back stomach and neck - denies any additional symptoms of concern. Have appt. today already scheduled with allergist Dr. Cypcor (state first noted itching at about 11:"45 11:45 am) rash eased within 15 minutes of Benadryl.


Changed on 1/7/2013

VAERS ID: 278152 Before After
Age:12.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-05-04
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Heart rate, Heart rate normal, Rash pruritic, Respiratory rate increased

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg 11:00am, Benadryl 50mg 1:12 pm
Current Illness: None known
Preexisting Conditions: allergy testing and injection (weekly) Tree, grass, and + allergy injection
Diagnostic Lab Data: Temp 97.5, BP 102/58, AHR 90 Resp. 24 Schedule for allergy tests with allergist in approximately one month
CDC 'Split Type':

Write-up:Student came to Student Health Center at 105 pm complaining of a pruritic rash on arms, back stomach and neck - denies any additional symptoms of concern. Have appt. today already scheduled with allergist Dr. Cypcor (state first noted itching at about 11:45 am) rash eased within 15 minutes of Benadryl.


Changed on 6/14/2014

VAERS ID: 278152 Before After
Age:12.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-05-04
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Heart rate, Heart rate normal, Rash pruritic, Respiratory rate increased

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg 11:00am, Benadryl 50mg 1:12 pm
Current Illness: None known
Preexisting Conditions: allergy testing and injection (weekly) Tree, grass, and + allergy injection
Diagnostic Lab Data: Temp 97.5, BP 102/58, AHR 90 Resp. 24 Schedule for allergy tests with allergist in approximately one month
CDC 'Split Type':

Write-up:Student came to Student Health Center at 105 pm complaining of a pruritic rash on arms, back stomach and neck - denies any additional symptoms of concern. Have appt. today already scheduled with allergist (state first noted itching at about 11:45 am) rash eased within 15 minutes of Benadryl.


Changed on 3/14/2015

VAERS ID: 278152 Before After
Age:12.0
Gender:Female
Location:North Carolina
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-05-04
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 1282F / 0 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B002AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Heart rate, Heart rate normal, Rash pruritic, Respiratory rate increased

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Acetaminophen 650 mg 11:00am, Benadryl 50mg 1:12 pm
Current Illness: None known
Preexisting Conditions: allergy testing and injection (weekly) Tree, grass, and + allergy injection
Diagnostic Lab Data: Temp 97.5, BP 102/58, AHR 90 Resp. 24 Schedule for allergy tests with allergist in approximately one month
CDC 'Split Type':

Write-up:Student came to Student Health Center at 105 pm complaining of a pruritic rash on arms, back stomach and neck - denies any additional symptoms of concern. Have appt. today already scheduled with allergist (state first noted itching at about 11:45 am) rash eased within 15 minutes of Benadryl.


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