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This is VAERS ID 278506

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278506
VAERS Form:
Age:18.0
Gender:Male
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Dizziness, Fatigue, Nausea, 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:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt complaining with nausea, dizziness, and fatigue, vomiting.


Changed on 12/8/2009

278506 Before After
VAERS Form:
Age:18.0
Gender:Male Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Dizziness, Fatigue, Nausea, 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:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt complaining with nausea, dizziness, and fatigue, vomiting.


Changed on 4/7/2010

278506 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2171AA / 0 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Fatigue, Nausea, 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:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt complaining with nausea, dizziness, and fatigue, vomiting.


Changed on 9/14/2017

278506 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Texas
Vaccinated:2007-05-14
Onset:2007-05-14
Submitted:2007-05-14
Entered:2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2171AA / 0 1 LA / IM

Administered by: Other      Purchased by: Other
Symptoms: Dizziness, Fatigue, Nausea, 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:
Current Illness:
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Pt complaining with nausea, dizziness, and fatigue, vomiting.


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