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This is VAERS ID 284293

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284293
VAERS Form:
Age:17.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-26
Onset:2007-06-29
Submitted:2007-07-11
Entered:2007-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB172AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2226AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthritis, C-reactive protein increased, Joint effusion, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: cefdinir for 10 days starting on 6/6/07 azithromycin for 5 days starting on 5/31
Current Illness: none
Preexisting Conditions: rash to amoxicillin dx''d in 2000
Allergies:
Diagnostic Lab Data: ESR 23 CRP 4.5
CDC 'Split Type':

Write-up:R hip and knee effusion; seen by orthopedics at ER of Hospital, ESR 23 CRP 4.5 felt to be c/w inflammatory, post-infectious type arthritis


Changed on 4/7/2010

284293 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-26
Onset:2007-06-29
Submitted:2007-07-11
Entered:2007-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB172AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2226AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthritis, C-reactive protein increased, Joint effusion, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: cefdinir for 10 days starting on 6/6/07 azithromycin for 5 days starting on 5/31
Current Illness: none
Preexisting Conditions: rash to amoxicillin dx''d in 2000
Allergies:
Diagnostic Lab Data: ESR 23 CRP 4.5
CDC 'Split Type':

Write-up:R hip and knee effusion; seen by orthopedics at ER of Hospital, ESR 23 CRP 4.5 felt to be c/w inflammatory, post-infectious type arthritis


Changed on 9/14/2017

284293 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-06-26
Onset:2007-06-29
Submitted:2007-07-11
Entered:2007-07-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB172AA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0523U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2226AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arthritis, C-reactive protein increased, Joint effusion, Red blood cell sedimentation rate increased

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: cefdinir for 10 days starting on 6/6/07 azithromycin for 5 days starting on 5/31
Current Illness: none
Preexisting Conditions: rash to amoxicillin dx''d in 2000
Allergies:
Diagnostic Lab Data: ESR 23 CRP 4.5
CDC 'Split Type':

Write-up:R hip and knee effusion; seen by orthopedics at ER of Hospital, ESR 23 CRP 4.5 felt to be c/w inflammatory, post-infectious type arthritis


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