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This is VAERS ID 284666

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284666
VAERS Form:
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-10
Onset:2007-07-11
Submitted:2007-07-11
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2572AA / 0 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0601U / 1 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Skin warm

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

Write-up:No fever, redness, slight swelling, RA, warm to touch, slightly firm advised to go to ER. Treatment per ER physician Claritin, Benadryl, Ibuprofen 200mg.


Changed on 9/14/2017

284666 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Georgia
Vaccinated:2007-07-10
Onset:2007-07-11
Submitted:2007-07-11
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB149AA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2572AA / 0 1 LA / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0601U / 1 2 RA / SC

Administered by: Public      Purchased by: Unknown
Symptoms: Erythema, Oedema peripheral, Skin warm

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

Write-up:No fever, redness, slight swelling, RA, warm to touch, slightly firm advised to go to ER. Treatment per ER physician Claritin, Benadryl, Ibuprofen 200mg.


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