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This is VAERS ID 279941

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279941
VAERS Form:
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 03666 / 0 LA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pruritus, Injection site urticaria

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

Write-up:26 hr after receiving varicella vaccine at our office pt. c/o Red hive like reaction at injections site-very itchy, given oral Benadryl-calamine to hive like rash with some relief-to continue this until gone or if worse refer to private provider. 5-22-07"parent reports 1 hive like rash-itchy remains at injection site


Changed on 12/8/2009

279941 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 03666 / 0 LA / SC

Administered by: Public      Purchased by: Unknown Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site urticaria

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

Write-up:26 hr after receiving varicella vaccine at our office clinic pt. c/o Red hive like reaction at injections site-very itchy, given oral Benadryl-calamine to hive like rash with some relief-to continue this until gone or if worse refer to private provider. 5-22-07"parent 5-22-07 parent reports 1 hive like rash-itchy remains at injection site


Changed on 9/14/2017

279941 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Michigan
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0962F / 0 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 03666 / 0 1 LA / SC

Administered by: Public      Purchased by: Private
Symptoms: Injection site erythema, Injection site pruritus, Injection site urticaria

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

Write-up:26 hr after receiving varicella vaccine at our clinic pt. c/o Red hive like reaction at injections site-very itchy, given oral Benadryl-calamine to hive like rash with some relief-to continue this until gone or if worse refer to private provider. 5-22-07 parent reports 1 hive like rash-itchy remains at injection site


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=279941&WAYBACKHISTORY=ON


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