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This is VAERS ID 424780

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2011

424780
VAERS Form:
Age:13.0
Gender:Female
Location:Washington
Vaccinated:2006-12-19
Onset:2007-02-02
Submitted:2011-06-04
Entered:2011-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2281AA / 0 LA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0804F / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Blood immunoglobulin A decreased, Fatigue, Lymphadenopathy, Malaise, Memory impairment, Neutropenia, Nuclear magnetic resonance imaging, Pharyngitis streptococcal, Pneumonia, Sinusitis, Stomatitis, Upper respiratory tract infection, X-ray, Blood test, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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:
Current Illness: no
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood, x-rays, MRI - as required
CDC 'Split Type':

Write-up:initial onset of on-going upper respiratory infections, swollen glands, sore throat, sinus infections, joint pain, fatigue, general unwell feeling, short term memory problems, mild neutropenia, pneumonia, strep throat, low IgA, mouth sores; on-going: not yet resolved


Changed on 7/7/2013

424780 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Washington
Vaccinated:2006-12-19
Onset:2007-02-02
Submitted:2011-06-04
Entered:2011-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2281AA / 0 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2281AA / 0 LA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0804F / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Blood immunoglobulin A decreased, Fatigue, Lymphadenopathy, Malaise, Memory impairment, Neutropenia, Nuclear magnetic resonance imaging, Pharyngitis streptococcal, Pneumonia, Sinusitis, Stomatitis, Upper respiratory tract infection, X-ray, Blood test, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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:
Current Illness: no
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood, x-rays, MRI - as required
CDC 'Split Type':

Write-up:initial onset of on-going upper respiratory infections, swollen glands, sore throat, sinus infections, joint pain, fatigue, general unwell feeling, short term memory problems, mild neutropenia, pneumonia, strep throat, low IgA, mouth sores; on-going: not yet resolved


Changed on 9/14/2017

424780 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Washington
Vaccinated:2006-12-19
Onset:2007-02-02
Submitted:2011-06-04
Entered:2011-06-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U2281AA / 0 1 LA / IM
HEPA: HEP A (VAQTA) / MERCK & CO. INC. 0804F / 1 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Arthralgia, Blood immunoglobulin A decreased, Fatigue, Lymphadenopathy, Malaise, Memory impairment, Neutropenia, Nuclear magnetic resonance imaging, Pharyngitis streptococcal, Pneumonia, Sinusitis, Stomatitis, Upper respiratory tract infection, X-ray, Blood test, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
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:
Current Illness: no
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: blood, x-rays, MRI - as required
CDC 'Split Type':

Write-up:initial onset of on-going upper respiratory infections, swollen glands, sore throat, sinus infections, joint pain, fatigue, general unwell feeling, short term memory problems, mild neutropenia, pneumonia, strep throat, low IgA, mouth sores; on-going: not yet resolved


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