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This is VAERS ID 278665

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278665
VAERS Form:
Age:12.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-13
Onset:2007-04-08
Submitted:2007-05-15
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2688AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2108AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:ILLNESS WITH HEADACHE, NAUSEA, VOMITING DIARRHEA AND FATIGUE FROM 4/8/07 - 4/13/07; RECEIVED GARDASIL VACCINATION ON 3/13/07; NO TREATMENT


Changed on 12/8/2009

278665 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-13
Onset:2007-04-08
Submitted:2007-05-15
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2688AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2108AA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Vomiting, Wrong drug administered

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:ILLNESS WITH HEADACHE, NAUSEA, VOMITING DIARRHEA AND FATIGUE FROM 4/8/07 - 4/13/07; RECEIVED GARDASIL VACCINATION ON 3/13/07; NO TREATMENT


Changed on 4/7/2010

278665 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-13
Onset:2007-04-08
Submitted:2007-05-15
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2688AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2108AA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Vomiting, Wrong drug administered

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:ILLNESS WITH HEADACHE, NAUSEA, VOMITING DIARRHEA AND FATIGUE FROM 4/8/07 - 4/13/07; RECEIVED GARDASIL VACCINATION ON 3/13/07; NO TREATMENT


Changed on 9/14/2017

278665 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Minnesota
Vaccinated:2007-03-13
Onset:2007-04-08
Submitted:2007-05-15
Entered:2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2688AA / 1 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2108AA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Vomiting, Wrong drug administered

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: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:ILLNESS WITH HEADACHE, NAUSEA, VOMITING DIARRHEA AND FATIGUE FROM 4/8/07 - 4/13/07; RECEIVED GARDASIL VACCINATION ON 3/13/07; NO TREATMENT


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