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This is VAERS ID 463963

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History of Changes from the VAERS Wayback Machine

First Appeared on 9/12/2012

VAERS ID: 463963
VAERS Form:
Age:14
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 0 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / - UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 9/14/2017

VAERS ID: 463963 Before After
VAERS Form:(blank) 1
Age:14 14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 0 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / - UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 2/14/2018

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 6/14/2018

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 8/14/2018

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 9/14/2018

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 10/14/2018

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 12/24/2020

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 12/30/2020

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 5/7/2021

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.


Changed on 5/21/2021

VAERS ID: 463963 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New Jersey
Vaccinated:2012-05-14
Onset:2012-05-14
Submitted:2012-09-04
Entered:2012-09-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113BB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 1295AA / UNK UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Fatigue, Influenza like illness, Nausea, Oedema peripheral, Pain

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:
Current Illness: Unknown
Preexisting Conditions: The subject had no concomitant medications and no known allergies.
Allergies:
Diagnostic Lab Data: UNK
CDC 'Split Type': A0991830A

Write-up: This case was reported by a physician, via a sales representative, and described the occurrence of body pain in a 14-year-old female subject who was vaccinated with CERVARIX (GlaxoSmithKline), VARIVAX (non-gsk). On 14 May 2012 at 16:30 the subject received 1st dose of CERVARIX (.5 ml, unknown route) and on 14 May 2012 the subject received 2nd dose of VARIVAX (Non-GSK) (details unknown). On 14 May 2012, 1 hour after vaccination with CERVARIX and VARIVAX (Non-GSK), the subject experienced "overall" body pain, swelling arm, flu like symptoms, fatigue and nausea. The physician considered the events were disabling. The events lasted for 3 days. On 17 May 2012, the events were resolved. The subject consulted her healthcare provider. The vaccination course with CERVARIX was discontinued.

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