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This is VAERS ID 282768

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

282768
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:2007-06-09
Onset:2007-06-11
Submitted:2007-06-15
Entered:2007-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2227AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0600U / 1 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Oedema peripheral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Swollen right arm, asthma attack on 6-13-07.


Changed on 12/8/2009

282768 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:2007-06-09
Onset:2007-06-11
Submitted:2007-06-15
Entered:2007-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2227AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0600U / 1 RA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthma, Oedema peripheral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Swollen right arm, asthma attack on 6-13-07.


Changed on 4/7/2010

282768 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:California
Vaccinated:2007-06-09
Onset:2007-06-11
Submitted:2007-06-15
Entered:2007-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2227AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0600U / 1 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthma, Oedema peripheral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Swollen right arm, asthma attack on 6-13-07.


Changed on 9/14/2017

282768 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:California
Vaccinated:2007-06-09
Onset:2007-06-11
Submitted:2007-06-15
Entered:2007-06-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0210U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2227AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0600U / 1 2 RA / SC

Administered by: Private      Purchased by: Private
Symptoms: Asthma, Oedema peripheral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
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: None
Preexisting Conditions: NKDA
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Swollen right arm, asthma attack on 6-13-07.


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