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This is VAERS ID 282270

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282270
VAERS Form:
Age:11.0
Gender:Female
Location:Minnesota
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-13
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2236AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0368U / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Culture throat positive, Injection site inflammation, Rash pruritic

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Throat culture for strep group A
CDC 'Split Type':

Write-up:Pruritic rash and immunization site inflammation - right arm 6/9/07 (vaccines 6/8/07)


Changed on 12/8/2009

282270 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Minnesota
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-13
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2236AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0368U / 1 LA / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Culture throat positive, Injection site inflammation, Rash pruritic

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Throat culture for strep group A
CDC 'Split Type':

Write-up:Pruritic rash and immunization site inflammation - right arm 6/9/07 (vaccines 6/8/07)


Changed on 4/7/2010

282270 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Minnesota
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-13
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2236AA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0368U / 1 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Culture throat positive, Injection site inflammation, Rash pruritic

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Throat culture for strep group A
CDC 'Split Type':

Write-up:Pruritic rash and immunization site inflammation - right arm 6/9/07 (vaccines 6/8/07)


Changed on 9/14/2017

282270 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Minnesota
Vaccinated:2007-06-08
Onset:2007-06-08
Submitted:2007-06-13
Entered:2007-06-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2236AA / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B007AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0368U / 1 2 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Culture throat positive, Injection site inflammation, Rash pruritic

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Throat culture for strep group A
CDC 'Split Type':

Write-up:Pruritic rash and immunization site inflammation - right arm 6/9/07 (vaccines 6/8/07)


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