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This is VAERS ID 30560

History of Changes from the VAERS Wayback Machine

Already in VAERS on 12/31/2003

VAERS ID: 30560
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE / UNCLASSIFIED - / - - / -
MMR: MMR II / MSD - / - - / -
TD: TD ADSORBED, ADULTS / LEDERLE 262905 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: EDEMA, PAIN

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: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': NA

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 12/8/2009

VAERS ID: 30560 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-22 1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: UNK. INFLUENZA VACCINE INFLUENZA (SEASONAL) (NO BRAND NAME) / UNCLASSIFIED UNKNOWN MANUFACTURER - / - - / -
MMR: MMR II MEASLES + MUMPS + RUBELLA (MMR II) / MSD MERCK & CO. INC. - / - - / -
TD: TD ADSORBED, ADULTS TD ADSORBED (NO BRAND NAME) / LEDERLE LEDERLE LABORATORIES 262905 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain, EDEMA, PAIN

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: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': NA 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 7/7/2013

VAERS ID: 30560 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 12/14/2016

VAERS ID: 30560 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 5/14/2017

VAERS ID: 30560 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / - - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 9/14/2017

VAERS ID: 30560 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / - UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / - UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 2/14/2018

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 6/14/2018

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 8/14/2018

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 9/14/2018

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 10/14/2018

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 12/24/2020

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 12/30/2020

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 5/7/2021

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;


Changed on 5/14/2021

VAERS ID: 30560 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:New York
Vaccinated:1990-12-04
Onset:1990-12-05
Submitted:0000-00-00
Entered:1991-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK - / -
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. - / UNK - / -
TD: TD ADSORBED (NO BRAND NAME) / LEDERLE LABORATORIES 262905 / UNK - / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Oedema, Pain

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: NA~ ()~~~In patient
Other Medications: NA
Current Illness: NA
Preexisting Conditions: NA
Allergies:
Diagnostic Lab Data: NA
CDC 'Split Type': 900216201

Write-up: 1day post vax entire arm was swollen, distal to the inject site, no redness, some soreness;

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=30560&WAYBACKHISTORY=ON

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