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This is VAERS ID 662875

History of Changes from the VAERS Wayback Machine

First Appeared on 12/14/2016

VAERS ID: 662875
VAERS Form:
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2016-10-31
Entered:2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22206A / - RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 0 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922AB / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B01HH / - RL / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Vomiting, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Steroid inhaler; NEXIUM; IMITREX; ZOFRAN
Current Illness: yes, we were in for a sick visit.
Preexisting Conditions: Acid Reflux, Hiatal Hernia, migraines
Allergies:
Diagnostic Lab Data: At this time Blood tests, and multiple dr''s. visits and communications with dr. and ER visits.
CDC 'Split Type':

Write-up: Dizziness, vomiting, numbness of extremities.


Changed on 9/14/2017

VAERS ID: 662875 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2016-10-31
Entered:2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22206A / - UNK RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 0 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922AB / 0 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B01HH / - UNK RL / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Vomiting, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Steroid inhaler; NEXIUM; IMITREX; ZOFRAN
Current Illness: yes, we were in for a sick visit.
Preexisting Conditions: Acid Reflux, Hiatal Hernia, migraines
Allergies:
Diagnostic Lab Data: At this time Blood tests, and multiple dr''s. visits and communications with dr. and ER visits.
CDC 'Split Type':

Write-up: Dizziness, vomiting, numbness of extremities.


Changed on 2/14/2018

VAERS ID: 662875 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2016-10-31
Entered:2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22206A / UNK RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922AB / 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B01HH / UNK RL / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Vomiting, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Steroid inhaler; NEXIUM; IMITREX; ZOFRAN
Current Illness: yes, we were in for a sick visit.
Preexisting Conditions: Acid Reflux, Hiatal Hernia, migraines
Allergies:
Diagnostic Lab Data: At this time Blood tests, and multiple dr''s. visits and communications with dr. and ER visits.
CDC 'Split Type':

Write-up: Dizziness, vomiting, numbness of extremities.


Changed on 6/14/2018

VAERS ID: 662875 Before After
VAERS Form:1
Age:12.0
Gender:Female
Location:Ohio
Vaccinated:2007-01-22
Onset:2007-01-22
Submitted:2016-10-31
Entered:2016-10-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR U22206A / UNK RA / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB143BA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1922AB / 1 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B01HH / UNK RL / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Hypoaesthesia, Vomiting, Blood test

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? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Steroid inhaler; NEXIUM; IMITREX; ZOFRAN
Current Illness: yes, we were in for a sick visit.
Preexisting Conditions: Acid Reflux, Hiatal Hernia, migraines
Allergies:
Diagnostic Lab Data: At this time Blood tests, and multiple dr''s. visits and communications with dr. and ER visits.
CDC 'Split Type':

Write-up: Dizziness, vomiting, numbness of extremities.

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