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From the 2/26/2021 release of VAERS data:

This is VAERS ID 267080

Case Details

VAERS ID: 267080 (history)  
Form: Version 1.0  
Age: 19.0  
Sex: Female  
Location: Florida  
   Days after vaccination:33
Submitted: 2006-11-14
   Days after onset:42
Entered: 2006-11-17
   Days after submission:3
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Other       Purchased by: Other
Symptoms: Abdominal pain, Feeling cold, Haemorrhage, Hot flush, Nausea, Pyrexia
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Insulin, Synthroid
Current Illness:
Preexisting Conditions: Diabetes, Hypothyroidism.
Diagnostic Lab Data:
CDC Split Type: WAES0611USA02762

Write-up: concerning a 19 year old female with diabetes and hypothyroidism on 8/31/06 was vaccainted IM with a first dose of HPV vaccine. Concomitant therapy included an insulin pump, Levothyroxine (Synthroid) and (Loworval). On 10/3/06 (also reported as a month later), the pt experienced hot flushes and cold flashed, nausea, a temp less than 100F and abnormal bleeding. On 11/4/06, the pt experienced right lower quadrant abdominal pain and was hospitalized. She has had a CAT scan, MRI, laparoscopy and a few ultrasounds of the area but all have been neg. The pt was treated wit IV fluids. At the time of this report, the pt had not recovered. No product quality complaint was involved. Right lower quadrant abdominal pain was considered to be an other important medical event (OMIC). Additional information has been requested.

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