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This is VAERS ID 281395

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281395
VAERS Form:
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-05
Onset:2007-06-06
Submitted:2007-06-07
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 017146109 / 0 LA / -
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 42058AA / 0 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0308U2109 / 1 RA / -

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Cold compress therapy

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

Write-up:Warm, red, pruritic area 2x3/" on Right deltoid. Tender to touch. Gave ice/melt on 20 minutes off 20 minutes.


Changed on 12/8/2009

281395 Before After
VAERS Form:
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-05
Onset:2007-06-06
Submitted:2007-06-07
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 017146109 / 0 LA / -
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 42058AA / 0 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0308U2109 / 1 RA / -

Administered by: Private      Purchased by: Unknown Public
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Cold compress therapy

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

Write-up:Warm, red, pruritic area 2x3/" 2x3" on Right deltoid. Tender to touch. Gave ice/melt on 20 minutes off 20 minutes.


Changed on 9/14/2017

281395 Before After
VAERS Form:(blank) 1
Age:
Gender:Female
Location:Arizona
Vaccinated:2007-06-05
Onset:2007-06-06
Submitted:2007-06-07
Entered:2007-06-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 017146109 / 0 1 LA / -
MMRV: MEASLES + MUMPS + RUBELLA + VARICELLA (PROQUAD) / MERCK & CO. INC. 42058AA / 0 1 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0308U2109 / 1 2 RA / -

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site pain, Injection site pruritus, Injection site warmth, Cold compress therapy

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

Write-up:Warm, red, pruritic area 2x3" on Right deltoid. Tender to touch. Gave ice/melt on 20 minutes off 20 minutes.


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