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This is VAERS ID 282239

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282239
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-05
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U12135AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blister, Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Vaccines given 5/29/07 and /"blistering/" rash appeared on L back and L abdomen on 5/30/07. Exam consistent with Herpes Zoster


Changed on 12/8/2009

282239 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-05
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U12135AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blister, Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Vaccines given 5/29/07 and /"blistering/" "blistering" rash appeared on L back and L abdomen on 5/30/07. Exam consistent with Herpes Zoster


Changed on 4/7/2010

282239 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-05
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U12135AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Vaccines given 5/29/07 and "blistering" rash appeared on L back and L abdomen on 5/30/07. Exam consistent with Herpes Zoster


Changed on 9/14/2017

282239 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Florida
Vaccinated:2007-05-29
Onset:2007-05-30
Submitted:2007-06-05
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U12135AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blister, Herpes zoster, Rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Vaccines given 5/29/07 and "blistering" rash appeared on L back and L abdomen on 5/30/07. Exam consistent with Herpes Zoster


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