National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 322230

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

322230
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 w"eek. Received Hep A & Varicella vaccines that day.


Changed on 12/8/2009

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Unknown Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 w"eek. week. Received Hep A & Varicella vaccines that day.


Changed on 1/5/2010

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No 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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines that day. tha


Changed on 4/7/2010

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Rash, Skin lesion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 4/13/2011

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 5/13/2011

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 6/11/2011

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 6/14/2014

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 4/14/2017

322230 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Full blood count normal, Rash, Skin lesion, Red blood cell sedimentation rate normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


Changed on 9/14/2017

322230 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Michigan
Vaccinated:2008-02-06
Onset:2008-08-04
Submitted:2008-08-14
Entered:2008-08-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1063U / 2 3 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2365AA / 0 1 RA / UN

Administered by: Other      Purchased by: Public
Symptoms: Rash, Skin lesion

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
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: In 2/08 was on Concerta; not now.
Current Illness: None Rash x 1 week.
Preexisting Conditions: NKDA; NSVD; ? Bipolar; NDKS
Allergies:
Diagnostic Lab Data: LABS: CBC & ESR WNL.
CDC 'Split Type':

Write-up:Left outer leg rash/lesion. Mother stated rash same appearance as seen on tv for rash reaction to immunization. 8/26/08 Reviewed PCP medical records of 8/4/2008. FINAL DX: vascular rash Records reveal patient experienced left outer leg & back rash x 1 week. Received Hep A & Varicella vaccines tha


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=322230&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166