National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 314847

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

VAERS ID: 314847
VAERS Form:
Age:9.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-29
Onset:2007-08-29
Submitted:2008-05-16
Entered:2008-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 658413/1025U / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Loss of consciousness, Immediate post-injection reaction

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

Write-up: Information has been received from a health professional concerning a 9 year old female with no pertinent medical history, drug reactions or allergies who on 29-AUG-2007 was vaccinated with a /"booster shot/" of varicella virus vaccine live (Oka/Merck) (L"ot # 658413/1025U). Concomitant therapy included human papillomavirus vaccine (GARDASIL). On 29-AUG-2007 the patient passed out immediately after receiving varicella virus vaccine live (Oka/Merck). There were no lab diagnostic studies performed. Unspecifi


Changed on 12/8/2009

VAERS ID: 314847 Before After
VAERS Form:
Age:9.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-29
Onset:2007-08-29
Submitted:2008-05-16
Entered:2008-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 658413/1025U / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Loss of consciousness, Immediate post-injection reaction

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:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': (blank) WAES0708USA05426

Write-up: Information has been received from a health professional concerning a 9 year old female with no pertinent medical history, drug reactions or allergies who on 29-AUG-2007 was vaccinated with a /"booster shot/" "booster shot" of varicella virus vaccine live (Oka/Merck) (L"ot (Lot # 658413/1025U). Concomitant therapy included human papillomavirus vaccine (GARDASIL). On 29-AUG-2007 the patient passed out immediately after receiving varicella virus vaccine live (Oka/Merck). There were no lab diagnostic studies performed. Unspecifi Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 314847 Before After
VAERS Form:(blank) 1
Age:9.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-29
Onset:2007-08-29
Submitted:2008-05-16
Entered:2008-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 658413/1025U / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness, Immediate post-injection reaction

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:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0708USA05426

Write-up: Information has been received from a health professional concerning a 9 year old female with no pertinent medical history, drug reactions or allergies who on 29-AUG-2007 was vaccinated with a "booster shot" of varicella virus vaccine live (Oka/Merck) (Lot # 658413/1025U). Concomitant therapy included human papillomavirus vaccine (GARDASIL). On 29-AUG-2007 the patient passed out immediately after receiving varicella virus vaccine live (Oka/Merck). There were no lab diagnostic studies performed. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 314847 Before After
VAERS Form:1
Age:9.0
Gender:Female
Location:Unknown
Vaccinated:2007-08-29
Onset:2007-08-29
Submitted:2008-05-16
Entered:2008-05-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 658413/1025U / UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Loss of consciousness, Immediate post-injection reaction

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:
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0708USA05426

Write-up: Information has been received from a health professional concerning a 9 year old female with no pertinent medical history, drug reactions or allergies who on 29-AUG-2007 was vaccinated with a "booster shot" of varicella virus vaccine live (Oka/Merck) (Lot # 658413/1025U). Concomitant therapy included human papillomavirus vaccine (GARDASIL). On 29-AUG-2007 the patient passed out immediately after receiving varicella virus vaccine live (Oka/Merck). There were no lab diagnostic studies performed. Unspecified medical attention was sought. There was no product quality complaint. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=314847&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166