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This is VAERS ID 394854

History of Changes from the VAERS Wayback Machine

First Appeared on 8/31/2010

VAERS ID: 394854
VAERS Form:
Age:16.0
Gender:Female
Location:Indiana
Vaccinated:2010-07-16
Onset:2010-07-16
Submitted:2010-08-10
Entered:2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Tachycardia

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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.


Changed on 6/14/2014

VAERS ID: 394854 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Indiana
Vaccinated:2010-07-16
Onset:2010-07-16
Submitted:2010-08-10
Entered:2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Tachycardia

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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.


Changed on 4/14/2017

VAERS ID: 394854 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Indiana
Vaccinated:2010-07-16
Onset:2010-07-16
Submitted:2010-08-10
Entered:2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Tachycardia

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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.


Changed on 9/14/2017

VAERS ID: 394854 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Indiana
Vaccinated:2010-07-16
Onset:2010-07-16
Submitted:2010-08-10
Entered:2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Tachycardia

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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.


Changed on 2/14/2018

VAERS ID: 394854 Before After
VAERS Form:1
Age:16.0
Gender:Female
Location:Indiana
Vaccinated:2010-07-16
Onset:2010-07-16
Submitted:2010-08-10
Entered:2010-08-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB379AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3098AA / 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Dyspnoea, Tachycardia

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: No
Preexisting Conditions: No
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Patient presented to office today (8-10-10) for GARDASIL #3 and reports she had difficulty breathing and tachycardia after receiving MCV-4 and HEP A #1 on 7-16-10. States symptoms started about 30 min after shots. Went to doctor. No tx given.

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