National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 279474

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279474
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-05-15
Onset:2007-05-17
Submitted:2007-05-18
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Body temperature, Injection site erythema, Injection site induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Retin-A 0.1% Topical cream
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None ordered
CDC 'Split Type':

Write-up:5/15/07 Child came in for well child exam visit; receiving Varicella and HPV vaccine. 5/17/07: Doctor visit progress notes read as follows: immunization 2 days ago, HPV and Varicella. Sibling also here with similar reaction. Temp 97.2F. Physical examinati"on: 1/2 dollar sized area of induration and erythema left arm at injection site. Adv- Benadryl, rech prn.


Changed on 12/8/2009

279474 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-05-15
Onset:2007-05-17
Submitted:2007-05-18
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 1 LA / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Body temperature, Injection site erythema, Injection site induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Retin-A 0.1% Topical cream
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None ordered
CDC 'Split Type':

Write-up:5/15/07 Child came in for well child exam visit; receiving Varicella and HPV vaccine. 5/17/07: Doctor visit progress notes read as follows: immunization 2 days ago, HPV and Varicella. Sibling also here with similar reaction. Temp 97.2F. Physical examinati"on: examination: 1/2 dollar sized area of induration and erythema left arm at injection site. Adv- Benadryl, rech prn.


Changed on 9/14/2017

279474 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:California
Vaccinated:2007-05-15
Onset:2007-05-17
Submitted:2007-05-18
Entered:2007-05-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 1 2 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Body temperature, Injection site erythema, Injection site induration

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: Retin-A 0.1% Topical cream
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None ordered
CDC 'Split Type':

Write-up:5/15/07 Child came in for well child exam visit; receiving Varicella and HPV vaccine. 5/17/07: Doctor visit progress notes read as follows: immunization 2 days ago, HPV and Varicella. Sibling also here with similar reaction. Temp 97.2F. Physical examination: 1/2 dollar sized area of induration and erythema left arm at injection site. Adv- Benadryl, rech prn.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279474&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166