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This is VAERS ID 284446

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 284446
VAERS Form:
Age:15.0
Gender:Female
Location:Oregon
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-12
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2232AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 1 RA / SC

Administered by: Private      Purchased by: Unknown
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

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: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


Changed on 12/8/2009

VAERS ID: 284446 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Oregon
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-12
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2232AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 1 RA / SC

Administered by: Private      Purchased by: Unknown Public
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

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: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


Changed on 4/7/2010

VAERS ID: 284446 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Oregon
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-12
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2232AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 0 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 1 RA / SC

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

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: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


Changed on 9/14/2017

VAERS ID: 284446 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Oregon
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-12
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 1 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2232AA / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 0 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 1 2 RA / SC

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

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: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


Changed on 2/14/2018

VAERS ID: 284446 Before After
VAERS Form:1
Age:15.0
Gender:Female
Location:Oregon
Vaccinated:2007-07-09
Onset:2007-07-09
Submitted:2007-07-12
Entered:2007-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0442U / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2232AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 1 RA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0609U / 2 RA / SC

Administered by: Private      Purchased by: Public
Symptoms: Injection site erythema, Injection site oedema, Injection site pain

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: Yaz, Claritin D
Current Illness:
Preexisting Conditions: Dysfunctional Uterine bleeding
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Back of R upper arm - redness area 8cm x 4cm with slight edema, pain at site - SQ injection of Varicella


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