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This is VAERS ID 279935

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279935
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-05-16
Onset:2007-05-17
Submitted:2007-05-21
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR 42223AA / 0 - / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Pruritus, Skin warm, 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)? 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:L arm developed large area of warm hard itchy (intense) induration


Changed on 12/8/2009

279935 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-05-16
Onset:2007-05-17
Submitted:2007-05-21
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR 42223AA / 0 - / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Pruritus, Skin warm, 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)? 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:L arm developed large area of warm hard itchy (intense) induration


Changed on 4/7/2010

279935 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-05-16
Onset:2007-05-17
Submitted:2007-05-21
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42223AA / 0 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Pruritus, Skin warm, 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)? 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:L arm developed large area of warm hard itchy (intense) induration


Changed on 9/14/2017

279935 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2007-05-16
Onset:2007-05-17
Submitted:2007-05-21
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42223AA / 0 1 - / IM

Administered by: Public      Purchased by: Public
Symptoms: Pruritus, Skin warm, 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)? 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:L arm developed large area of warm hard itchy (intense) induration


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