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This is VAERS ID 1847020

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History of Changes from the VAERS Wayback Machine

First Appeared on 11/12/2021

VAERS ID: 1847020
VAERS Form:2
Age:1.25
Sex:Male
Location:Utah
Vaccinated:2021-10-18
Onset:2021-10-29
Submitted:0000-00-00
Entered:2021-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C5765BA / 4 LL / IM
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT) / SANOFI PASTEUR UT7383NA / 3 - / -
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. UT574AA / 4 RL / IM
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. U010397 / 1 LL / SC

Administered by: Private      Purchased by: ??
Symptoms: Injection site induration, Injection site swelling

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: Cystic Fibrosis
Allergies: none
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: Mom noticed a quarter size bump on the child''s leg. The bump was hard to touch. Mom noticed the bump 10/29/21. No treatment done at this time.

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