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This is VAERS ID 283896

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

283896
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-03
Onset:2007-07-04
Submitted:2007-07-05
Entered:2007-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2B2UAA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B0118BA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0115U / 1 LA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Erythema, Neck pain, Tenderness

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

Write-up:6CM AREA OF ERYTHEMA, TENDERNESS TO LEFT ARM. SLIGHT NECK PAIN, BUT FULL RANGE OF MOTION


Changed on 12/8/2009

283896 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-03
Onset:2007-07-04
Submitted:2007-07-05
Entered:2007-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2B2UAA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B0118BA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0115U / 1 LA / SC

Administered by: Private      Purchased by: Unknown Private
Symptoms: Erythema, Neck pain, Tenderness

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

Write-up:6CM AREA OF ERYTHEMA, TENDERNESS TO LEFT ARM. SLIGHT NECK PAIN, BUT FULL RANGE OF MOTION


Changed on 4/7/2010

283896 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-03
Onset:2007-07-04
Submitted:2007-07-05
Entered:2007-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2B2UAA / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B0118BA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0115U / 1 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Neck pain, Tenderness

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

Write-up:6CM AREA OF ERYTHEMA, TENDERNESS TO LEFT ARM. SLIGHT NECK PAIN, BUT FULL RANGE OF MOTION


Changed on 9/14/2017

283896 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-03
Onset:2007-07-04
Submitted:2007-07-05
Entered:2007-07-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2B2UAA / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B0118BA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0115U / 1 2 LA / SC

Administered by: Private      Purchased by: Private
Symptoms: Erythema, Neck pain, Tenderness

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

Write-up:6CM AREA OF ERYTHEMA, TENDERNESS TO LEFT ARM. SLIGHT NECK PAIN, BUT FULL RANGE OF MOTION


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