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This is VAERS ID 278478

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 278478
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 5 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 12/8/2009

VAERS ID: 278478 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 5 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown Public
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 9/14/2014

VAERS ID: 278478 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 5 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 1 LA / IM

Administered by: Private Unknown      Purchased by: Public Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 9/14/2017

VAERS ID: 278478 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 1 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 1 2 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 5 6 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 1 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 2/14/2018

VAERS ID: 278478 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 2 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 6 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 6/14/2018

VAERS ID: 278478 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 2 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 6 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever


Changed on 8/14/2018

VAERS ID: 278478 Before After
VAERS Form:1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-10
Onset:2007-05-11
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 2 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 6 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting

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: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: vomiting, diarrea, fever

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