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This is VAERS ID 282710

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282710
VAERS Form:
Age:10.0
Gender:Female
Location:California
Vaccinated:2007-06-19
Onset:2007-06-19
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / - LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / - LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site warmth, Injection site swelling

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

Write-up:Redness, heat and mild swelling to left upper arm at injection site. Denies pain.


Changed on 12/8/2009

282710 Before After
VAERS Form:
Age:10.0
Gender:Female
Location:California
Vaccinated:2007-06-19
Onset:2007-06-19
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / - LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / - LA / SC

Administered by: Private      Purchased by: Unknown Public
Symptoms: Injection site erythema, Injection site warmth, Injection site swelling

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

Write-up:Redness, heat and mild swelling to left upper arm at injection site. Denies pain.


Changed on 9/14/2017

282710 Before After
VAERS Form:(blank) 1
Age:10.0
Gender:Female
Location:California
Vaccinated:2007-06-19
Onset:2007-06-19
Submitted:2007-06-21
Entered:2007-06-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0171U / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / - UNK LA / IM
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 2 3 LA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1250F / - UNK LA / SC

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site warmth, Injection site swelling

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

Write-up:Redness, heat and mild swelling to left upper arm at injection site. Denies pain.


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