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This is VAERS ID 278157

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278157
VAERS Form:
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-04-30
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / - RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Ecchymosis, Erythema, Rash, Skin warm, Tenderness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Increased Wt. gain
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up:3/12/" x 3/12/" x 3/" Red, circular rash in area of ecclymosisin center. Mild tenderness, and warmth.


Changed on 12/8/2009

278157 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-04-30
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 RA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / - RA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Ecchymosis, Erythema, Rash, Skin warm, Tenderness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Increased Wt. gain
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up:3/12/" 3/12" x 3/12/" 3/12" x 3/" 3" Red, circular rash in area of ecclymosisin center. Mild tenderness, and warmth.


Changed on 9/14/2017

278157 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Tennessee
Vaccinated:2007-04-27
Onset:2007-04-27
Submitted:2007-04-30
Entered:2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1426F / 0 1 RA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / - UNK RA / IM

Administered by: Private      Purchased by: Public
Symptoms: Ecchymosis, Erythema, Rash, Skin warm, Tenderness

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: Increased Wt. gain
Allergies:
Diagnostic Lab Data: N/A
CDC 'Split Type':

Write-up:3/12" x 3/12" x 3" Red, circular rash in area of ecclymosisin center. Mild tenderness, and warmth.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=278157&WAYBACKHISTORY=ON


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