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This is VAERS ID 283997

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

283997
VAERS Form:
Age:13.0
Gender:Female
Location:Texas
Vaccinated:2007-06-18
Onset:2007-06-19
Submitted:2007-06-20
Entered:2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR 42208AA / 0 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 05U5U / - RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Anorexia, Dizziness, Injection site erythema, Injection site pain, Injection site pruritus

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: Dytancs, Motrin, Westcort
Current Illness: Upper respiratory infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:injection site RXN - 8-8.5 annular, raised erythematous lesion, painful, pruritic to R arm systemic RX - lower limb weakness, dizziness, loss of appetite, fever.


Changed on 12/8/2009

283997 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Texas
Vaccinated:2007-06-18
Onset:2007-06-19
Submitted:2007-06-20
Entered:2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR 42208AA / 0 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 05U5U / - RA / SC

Administered by: Private      Purchased by: Unknown Other
Symptoms: Anorexia, Dizziness, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Muscular weakness, Pyrexia

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: Dytancs, Motrin, Westcort
Current Illness: Upper respiratory infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:injection site RXN - 8-8.5 annular, raised erythematous lesion, painful, pruritic to R arm systemic RX - lower limb weakness, dizziness, loss of appetite, fever.


Changed on 4/7/2010

283997 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Texas
Vaccinated:2007-06-18
Onset:2007-06-19
Submitted:2007-06-20
Entered:2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 LA / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42208AA / 0 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 05U5U / - RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Anorexia, Dizziness, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Muscular weakness, Pyrexia

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: Dytancs, Motrin, Westcort
Current Illness: Upper respiratory infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:injection site RXN - 8-8.5 annular, raised erythematous lesion, painful, pruritic to R arm systemic RX - lower limb weakness, dizziness, loss of appetite, fever.


Changed on 9/14/2017

283997 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Texas
Vaccinated:2007-06-18
Onset:2007-06-19
Submitted:2007-06-20
Entered:2007-07-06
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR 42208AA / 0 1 RA / -
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 05U5U / - UNK RA / SC

Administered by: Private      Purchased by: Other
Symptoms: Anorexia, Dizziness, Injection site erythema, Injection site pain, Injection site pruritus, Injection site rash, Injection site reaction, Muscular weakness, Pyrexia

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: Dytancs, Motrin, Westcort
Current Illness: Upper respiratory infection
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:injection site RXN - 8-8.5 annular, raised erythematous lesion, painful, pruritic to R arm systemic RX - lower limb weakness, dizziness, loss of appetite, fever.


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