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This is VAERS ID 282734

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282734
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-23
Onset:2007-06-23
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1501F / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Heart rate decreased, Pallor, Musculoskeletal stiffness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After 3 minutes of the application, the patient got paleness, weakness, shakeness, generalized stiffness. She asked then /"What happened? The BP went down to 80/60, and heart rate around 50''''s. The situation resolved in 15 minutes. No aditional treatment"was given.


Changed on 12/8/2009

282734 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-23
Onset:2007-06-23
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1501F / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Heart rate decreased, Pallor, Tremor, Musculoskeletal stiffness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After 3 minutes of the application, the patient got paleness, weakness, shakeness, generalized stiffness. She asked then /"What "What happened? The BP went down to 80/60, and heart rate around 50''''s. 50''s. The situation resolved in 15 minutes. No aditional treatment"was treatment was given.


Changed on 4/7/2010

282734 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-23
Onset:2007-06-23
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1501F / 0 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Heart rate decreased, Pallor, Tremor, Musculoskeletal stiffness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After 3 minutes of the application, the patient got paleness, weakness, shakeness, generalized stiffness. She asked then "What happened? The BP went down to 80/60, and heart rate around 50''s. The situation resolved in 15 minutes. No aditional treatment was given.


Changed on 9/14/2017

282734 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Illinois
Vaccinated:2007-06-23
Onset:2007-06-23
Submitted:2007-06-23
Entered:2007-06-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0012U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2183AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1501F / 0 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood pressure decreased, Heart rate decreased, Pallor, Tremor, Musculoskeletal stiffness

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:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:After 3 minutes of the application, the patient got paleness, weakness, shakeness, generalized stiffness. She asked then "What happened? The BP went down to 80/60, and heart rate around 50''s. The situation resolved in 15 minutes. No aditional treatment was given.


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