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This is VAERS ID 283658

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

283658
VAERS Form:
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-06-22
Onset:2007-06-23
Submitted:2007-06-25
Entered:2007-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0469U / - LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2731AA / - RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Pain, Pruritus, Swelling

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

Write-up:Swelling and itching and pain 5/10


Changed on 9/14/2017

283658 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:California
Vaccinated:2007-06-22
Onset:2007-06-23
Submitted:2007-06-25
Entered:2007-07-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0469U / - UNK LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2731AA / - UNK RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0455U / 1 2 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Pain, Pruritus, Swelling

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

Write-up:Swelling and itching and pain 5/10


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=283658&WAYBACKHISTORY=ON


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