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This is VAERS ID 279995

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

279995
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-05-22
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2224AA / 1 RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Medication error, Unevaluable event

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 Known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None noted. 06/07/07-Spoke with reporter, the patients received a second dose of Menactra by mistake.


Changed on 12/8/2009

279995 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-05-22
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2224AA / 1 RA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Medication error, Unevaluable event

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 Known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None noted. 06/07/07-Spoke with reporter, the patients received a second dose of Menactra by mistake.


Changed on 4/7/2010

279995 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-05-22
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2224AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Medication error, Unevaluable event

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 Known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None noted. 06/07/07-Spoke with reporter, the patients received a second dose of Menactra by mistake.


Changed on 5/14/2017

279995 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-05-22
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2224AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Medication error, Unevaluable event

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 Known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None noted. 06/07/07-Spoke with reporter, the patients received a second dose of Menactra by mistake.


Changed on 9/14/2017

279995 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Michigan
Vaccinated:2007-05-22
Onset:0000-00-00
Submitted:2007-05-22
Entered:2007-05-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2224AA / 1 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Unevaluable event

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 Known
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:None noted. 06/07/07-Spoke with reporter, the patients received a second dose of Menactra by mistake.


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