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This is VAERS ID 1829430

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/5/2021

VAERS ID: 1829430
VAERS Form:2
Age:1.5
Sex:Male
Location:Michigan
Vaccinated:2021-10-26
Onset:2021-10-26
Submitted:0000-00-00
Entered:2021-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (INFANRIX) / GLAXOSMITHKLINE BIOLOGICALS 5RM39 / UNK LL / IM
FLU4: INFLUENZA (SEASONAL) (FLULAVAL QUADRIVALENT) / GLAXOSMITHKLINE BIOLOGICALS CJ554 / UNK RL / IM
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS 532H4 / UNK RL / IM

Administered by: Private      Purchased by: ??
Symptoms: Crying, Injection site erythema, Injection site induration, Irritability, Skin reaction, Injection site swelling, Injection site discomfort

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? No
Previous Vaccinations: DTAP-10/26/2020, 09/02/2020, 06/26/2020
Other Medications: None
Current Illness: Viral illness
Preexisting Conditions: None known
Allergies: None known
Diagnostic Lab Data: None currently ordered.
CDC 'Split Type':

Write-up: Patient developed local skin reaction of redness, swelling, induration, and discomfort at the injection site. Mom reports similar reaction in the past with worsening with subsequence injections. Mom reports that reaction started by 06:00 pm on the date of immunization and continued to worsen. Vaccination was given on 10/26/2021 and mom reports worsening until 10/28/2021. The redness, swelling, induration, and discomfort improved somewhat on 10/29/2021, but then patient became irritable and crying for unknown reason. Mom brought him into clinic to be assessed on 10/29/2021 due to vaccine reaction. She showed me images of redness and swelling of patient''s leg from prior days which was more red and swollen in the

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