National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 571471

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2015

VAERS ID: 571471
VAERS Form:
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / - RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


Changed on 9/14/2017

VAERS ID: 571471 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / - UNK RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


Changed on 2/14/2018

VAERS ID: 571471 Before After
VAERS Form:1
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / UNK RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


Changed on 6/14/2018

VAERS ID: 571471 Before After
VAERS Form:1
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / UNK RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


Changed on 8/14/2018

VAERS ID: 571471 Before After
VAERS Form:1
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / UNK RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.


Changed on 9/14/2018

VAERS ID: 571471 Before After
VAERS Form:1
Age:11.0
Gender:Male
Location:Vermont
Vaccinated:2015-03-12
Onset:0000-00-00
Submitted:2015-03-12
Entered:2015-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4923BA / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C4689AA / UNK RA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Ear infection, Injection site erythema, Injection site warmth

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up: Patient with local erythema and warmth and circular patch overlying both injection sites. Currently on CEFZIL to treat ear infection. Treated with MOTRIN and antihistamine.

New Search

Link To This Search Result:

https://medalerts.org/vaersdb/findfield.php?IDNUMBER=571471&WAYBACKHISTORY=ON


Copyright © 2018 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166