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This is VAERS ID 279151

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279151
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-14
Onset:2007-05-15
Submitted:2007-05-16
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 03040 / 1 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 LA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2454AA / 4 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1512F / 1 RA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Redness and swelling right deltoid region after 1 day.


Changed on 9/14/2017

279151 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-14
Onset:2007-05-15
Submitted:2007-05-16
Entered:2007-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 03040 / 1 2 RA / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 0 1 LA / -
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2454AA / 4 5 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1512F / 1 2 RA / -

Administered by: Other      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site swelling

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Redness and swelling right deltoid region after 1 day.


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Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279151&WAYBACKHISTORY=ON


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