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This is VAERS ID 278398

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278398
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-04-27
Onset:2007-05-01
Submitted:2007-05-02
Entered:2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1968AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 01736 / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Migraine, Sinusitis

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines on 4-27-07 - varicella, Menactra, Tdap, Hep A, HPV. Dx with Sinusitis and migraine Type headache on 5-1-07. Returned to the office on 5-2-07 with probable migraine Dx.


Changed on 12/8/2009

278398 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-04-27
Onset:2007-05-01
Submitted:2007-05-02
Entered:2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U1968AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 01736 / 1 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Migraine, Sinusitis

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines on 4-27-07 - varicella, Menactra, Tdap, Hep A, HPV. Dx with Sinusitis and migraine Type headache on 5-1-07. Returned to the office on 5-2-07 with probable migraine Dx.


Changed on 4/7/2010

278398 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-04-27
Onset:2007-05-01
Submitted:2007-05-02
Entered:2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / - LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 01736 / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Migraine, Sinusitis

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines on 4-27-07 - varicella, Menactra, Tdap, Hep A, HPV. Dx with Sinusitis and migraine Type headache on 5-1-07. Returned to the office on 5-2-07 with probable migraine Dx.


Changed on 9/14/2017

278398 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-04-27
Onset:2007-05-01
Submitted:2007-05-02
Entered:2007-05-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0188U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1968AA / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / - UNK LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 01736 / 1 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Migraine, Sinusitis

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:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Received vaccines on 4-27-07 - varicella, Menactra, Tdap, Hep A, HPV. Dx with Sinusitis and migraine Type headache on 5-1-07. Returned to the office on 5-2-07 with probable migraine Dx.


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