National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 348025

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

348025
VAERS Form:
Age:9.0
Gender:Female
Location:Pennsylvania
Vaccinated:2008-04-09
Onset:2008-04-10
Submitted:2009-05-15
Entered:2009-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1654U / 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site lymphadenopathy

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:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0804USA03185

Write-up:Information has been received from a registered nurse concerning a 9 year old patient with a history of premature puberty and asthma and a drug reaction/allergies that included an unknown reaction to flu vaccine, who on 09-APR-2008 was vaccinated IM with a dose of VARIVAX (Merck) (lot number: 659610/1654U). Suspect therapy included GARDASIL. On 10-APR-2008 the patient developed local swelling, redness and a lump under the skin at the injection site. Recommended treatment was ice and MOTRIN. There were no lab diagnostic studies performed. Unspecified medical attention was sought, via phone call to the office. The outcome was reported as recovering. There was no product quality complaint. Follow-up information from the reporting medical assistant (also reported as registered nurse) indicated that the 9 year old female who on 09-APR-2008 at 12:00 was vaccinated IM with her second dose of VARIVAX (Merck) (lot# 659610/1654U). After vaccination the patient developed redness and swelling. Additional information has been requested.


Changed on 9/14/2017

348025 Before After
VAERS Form:(blank) 1
Age:9.0
Gender:Female
Location:Pennsylvania
Vaccinated:2008-04-09
Onset:2008-04-10
Submitted:2009-05-15
Entered:2009-05-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1654U / 1 2 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Injection site erythema, Injection site swelling, Injection site lymphadenopathy

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:
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type': WAES0804USA03185

Write-up:Information has been received from a registered nurse concerning a 9 year old patient with a history of premature puberty and asthma and a drug reaction/allergies that included an unknown reaction to flu vaccine, who on 09-APR-2008 was vaccinated IM with a dose of VARIVAX (Merck) (lot number: 659610/1654U). Suspect therapy included GARDASIL. On 10-APR-2008 the patient developed local swelling, redness and a lump under the skin at the injection site. Recommended treatment was ice and MOTRIN. There were no lab diagnostic studies performed. Unspecified medical attention was sought, via phone call to the office. The outcome was reported as recovering. There was no product quality complaint. Follow-up information from the reporting medical assistant (also reported as registered nurse) indicated that the 9 year old female who on 09-APR-2008 at 12:00 was vaccinated IM with her second dose of VARIVAX (Merck) (lot# 659610/1654U). After vaccination the patient developed redness and swelling. Additional information has been requested.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=348025&WAYBACKHISTORY=ON


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