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This is VAERS ID 281108

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281108
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-11
Onset:2007-06-01
Submitted:2007-06-15
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 1 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2082AA / 0 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Varicella, Varicella post vaccine

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: thyroid goiter
Allergies:
Diagnostic Lab Data: vv
CDC 'Split Type':

Write-up:Patient had chickenpox after receiving varicella immunization. Had mild amount of involvement of legs, chrisind face.


Changed on 4/7/2010

281108 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-11
Onset:2007-06-01
Submitted:2007-06-15
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 1 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / 0 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 0 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Varicella, Varicella post vaccine

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: thyroid goiter
Allergies:
Diagnostic Lab Data: vv
CDC 'Split Type':

Write-up:Patient had chickenpox after receiving varicella immunization. Had mild amount of involvement of legs, chrisind face.


Changed on 9/14/2017

281108 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-05-11
Onset:2007-06-01
Submitted:2007-06-15
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 1 2 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2082AA / 0 1 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0369U / 0 1 LA / -

Administered by: Public      Purchased by: Unknown
Symptoms: Varicella, Varicella post vaccine

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: thyroid goiter
Allergies:
Diagnostic Lab Data: vv
CDC 'Split Type':

Write-up:Patient had chickenpox after receiving varicella immunization. Had mild amount of involvement of legs, chrisind face.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=281108&WAYBACKHISTORY=ON


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