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This is VAERS ID 282553

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 282553
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-28
Onset:2007-01-01
Submitted:2007-05-25
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Rash, Urticaria

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: Allergic reaction to antibiotics
Preexisting Conditions: Rash
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Initial information has been received from a nurse practitioner concerning a 19 year old, female, who reportedly developed a rash with Ceclor, whose reported weight was 175 pounds (lbs) and whose reported height was 66 and 1/2 inches (in), who had no illn"ess at the time of vaccination, who on 15-DEC-2006 was vaccinated intramuscularly, into the arm with her first dose of Gardasil, (lot # 653978/0955F), (WAES # 0701USA00254). On 28-DEC-2006 (also reported as 28-DEC-2007), the patient was vaccinated into th


Changed on 12/8/2009

VAERS ID: 282553 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-28
Onset:2007-01-01
Submitted:2007-05-25
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Rash, Urticaria

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: Allergic reaction to antibiotics
Preexisting Conditions: Rash
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0702USA00964

Write-up: Initial information has been received from a nurse practitioner concerning a 19 year old, female, who reportedly developed a rash with Ceclor, whose reported weight was 175 pounds (lbs) and whose reported height was 66 and 1/2 inches (in), who had no illn"ess illness at the time of vaccination, who on 15-DEC-2006 was vaccinated intramuscularly, into the arm with her first dose of Gardasil, (lot # 653978/0955F), (WAES # 0701USA00254). On 28-DEC-2006 (also reported as 28-DEC-2007), the patient was vaccinated into th the left arm with hepatitis A virus vaccine inactivated (Lot # AHAUB1Y1AA), (manufacturer unknown). It was reported that on 01-JAN-2007, the patient developed hives and rash on chest. At the time of report it was unknown if the patient recovered. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 282553 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-28
Onset:2007-01-01
Submitted:2007-05-25
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Rash, Urticaria

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: Allergic reaction to antibiotics
Preexisting Conditions: Rash
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00964

Write-up: Initial information has been received from a nurse practitioner concerning a 19 year old, female, who reportedly developed a rash with Ceclor, whose reported weight was 175 pounds (lbs) and whose reported height was 66 and 1/2 inches (in), who had no illness at the time of vaccination, who on 15-DEC-2006 was vaccinated intramuscularly, into the arm with her first dose of Gardasil, (lot # 653978/0955F), (WAES # 0701USA00254). On 28-DEC-2006 (also reported as 28-DEC-2007), the patient was vaccinated into the left arm with hepatitis A virus vaccine inactivated (Lot # AHAUB1Y1AA), (manufacturer unknown). It was reported that on 01-JAN-2007, the patient developed hives and rash on chest. At the time of report it was unknown if the patient recovered. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 282553 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-28
Onset:2007-01-01
Submitted:2007-05-25
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Rash, Urticaria

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: Allergic reaction to antibiotics
Preexisting Conditions: Rash
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00964

Write-up: Initial information has been received from a nurse practitioner concerning a 19 year old, female, who reportedly developed a rash with Ceclor, whose reported weight was 175 pounds (lbs) and whose reported height was 66 and 1/2 inches (in), who had no illness at the time of vaccination, who on 15-DEC-2006 was vaccinated intramuscularly, into the arm with her first dose of Gardasil, (lot # 653978/0955F), (WAES # 0701USA00254). On 28-DEC-2006 (also reported as 28-DEC-2007), the patient was vaccinated into the left arm with hepatitis A virus vaccine inactivated (Lot # AHAUB1Y1AA), (manufacturer unknown). It was reported that on 01-JAN-2007, the patient developed hives and rash on chest. At the time of report it was unknown if the patient recovered. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 282553 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-28
Onset:2007-01-01
Submitted:2007-05-25
Entered:2007-06-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Rash, Urticaria

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: Allergic reaction to antibiotics
Preexisting Conditions: Rash
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0702USA00964

Write-up: Initial information has been received from a nurse practitioner concerning a 19 year old, female, who reportedly developed a rash with Ceclor, whose reported weight was 175 pounds (lbs) and whose reported height was 66 and 1/2 inches (in), who had no illness at the time of vaccination, who on 15-DEC-2006 was vaccinated intramuscularly, into the arm with her first dose of Gardasil, (lot # 653978/0955F), (WAES # 0701USA00254). On 28-DEC-2006 (also reported as 28-DEC-2007), the patient was vaccinated into the left arm with hepatitis A virus vaccine inactivated (Lot # AHAUB1Y1AA), (manufacturer unknown). It was reported that on 01-JAN-2007, the patient developed hives and rash on chest. At the time of report it was unknown if the patient recovered. Additional information has been requested.

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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=282553&WAYBACKHISTORY=ON


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