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This is VAERS ID 279430

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279430
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 12/8/2009

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Unknown Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 8/31/2010

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 4/13/2011

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 5/13/2011

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 6/11/2011

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 5/14/2017

279430 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Differential white blood cell count, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


Changed on 9/14/2017

279430 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Wisconsin
Vaccinated:2007-04-10
Onset:2007-05-14
Submitted:2007-05-22
Entered:2007-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 LA / IM
TTOX: TETANUS TOXOID (TEVAX) / GLAXOSMITHKLINE BIOLOGICALS AC52B014BA / - UNK LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Arthritis, C-reactive protein, Full blood count, Oedema peripheral, Pain in extremity, Red blood cell sedimentation rate, X-ray limb

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: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: C-reactive protein, X-ray foot, CBC with diff, Sedimentation rate
CDC 'Split Type':

Write-up:Painful, swollen left heel without trauma arthritis left foot.


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