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This is VAERS ID 629103

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2016

VAERS ID: 629103
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 2 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 1 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 9/14/2017

VAERS ID: 629103 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 2 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 1 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 2/14/2018

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 6/14/2018

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 8/14/2018

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 9/14/2018

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 10/14/2018

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 12/24/2020

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 12/30/2020

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 5/7/2021

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).


Changed on 5/21/2021

VAERS ID: 629103 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2016-02-15
Onset:2016-02-17
Submitted:2016-03-24
Entered:2016-03-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L045711 / 3 LA / IM
MENB: MENINGOCOCCAL B (BEXSERO) / NOVARTIS VACCINES AND DIAGNOSTICS 151301D / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5180AA / 2 RA / IM

Administered by: Public      Purchased by: Public
Symptoms: Injection site rash

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Localized rash at injection site (right deltoid area).

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