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This is VAERS ID 268036

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

268036
VAERS Form:
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CT as above
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 wh"ich revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time.


Changed on 12/8/2009

268036 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: PMH: none Allergies: none
Allergies:
Diagnostic Lab Data: Labs and Diagnoatics: WBC''s 11.0, Abdominal CT as above shows a thickened appendix at the base of the cecum with surrounding inflammation c/w acute appendicitis.
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 wh"ich which revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time. Student health office note of 11/28/06 recording administration of Gardasil #1 on this date. Hospital record received revealing a 20 year old woman who developed crampy abdominal pain centered in the right lower quadrant 1 day following her Gardasil vax. Patient had appendectomy and was dischaged home the following day. DX: Appendicitis.


Changed on 1/5/2010

268036 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: PMH: none Allergies: none
Allergies:
Diagnostic Lab Data: Labs and Diagnoatics: WBC''s 11.0, Abdominal CT shows a thickened appendix at the base of the cecum with surrounding inflammation c/w acute appendicitis.
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 which revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time. Student health office note of 11/28/06 recording administration of Gardasil GARDASIL #1 on this date. Hospital record received revealing a 20 year old woman who developed crampy abdominal pain centered in the right lower quadrant 1 day following her Gardasil GARDASIL vax. Patient had appendectomy and was dischaged home the following day. DX: Appendicitis. She recovered her 2nd GARDASIL vaccination here on 2/8/2007.


Changed on 6/14/2014

268036 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: PMH: none Allergies: none
Allergies:
Diagnostic Lab Data: Labs and Diagnoatics: WBC''s 11.0, Abdominal CT shows a thickened appendix at the base of the cecum with surrounding inflammation c/w acute appendicitis.
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 which revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time. Student health office note of 11/28/06 recording administration of GARDASIL #1 on this date. Hospital record received revealing a 20 year old woman who developed crampy abdominal pain centered in the right lower quadrant 1 day following her GARDASIL vax. Patient had appendectomy and was dischaged home the following day. DX: Appendicitis. She recovered her 2nd GARDASIL vaccination here on 2/8/2007.


Changed on 5/14/2017

268036 Before After
VAERS Form:
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: PMH: none Allergies: none
Allergies:
Diagnostic Lab Data: Labs and Diagnoatics: WBC''s 11.0, Abdominal CT shows a thickened appendix at the base of the cecum with surrounding inflammation c/w acute appendicitis.
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 which revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time. Student health office note of 11/28/06 recording administration of GARDASIL #1 on this date. Hospital record received revealing a 20 year old woman who developed crampy abdominal pain centered in the right lower quadrant 1 day following her GARDASIL vax. Patient had appendectomy and was dischaged home the following day. DX: Appendicitis. She recovered her 2nd GARDASIL vaccination here on 2/8/2007.


Changed on 9/14/2017

268036 Before After
VAERS Form:(blank) 1
Age:20.0
Gender:Female
Location:Iowa
Vaccinated:2006-11-28
Onset:2006-11-28
Submitted:2006-11-30
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Abdominal pain lower, Gastrointestinal disorder, Laboratory test abnormal, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Ortho Tri-Cyclen Lo
Current Illness: none
Preexisting Conditions: PMH: none Allergies: none
Allergies:
Diagnostic Lab Data: Labs and Diagnoatics: WBC''s 11.0, Abdominal CT shows a thickened appendix at the base of the cecum with surrounding inflammation c/w acute appendicitis.
CDC 'Split Type':

Write-up:Less than 3 hours following the vaccination she developed severe abdominal cramps and vomited. Subsequently had persistent abdominal pain that eventually localized to the right lower quadrant. A CT of the abdomen was performed the evening of 11/29/06 which revealed appendicitis. A surgical consultation was requested and days of hospitalization are unknown yet at this time. Student health office note of 11/28/06 recording administration of GARDASIL #1 on this date. Hospital record received revealing a 20 year old woman who developed crampy abdominal pain centered in the right lower quadrant 1 day following her GARDASIL vax. Patient had appendectomy and was dischaged home the following day. DX: Appendicitis. She recovered her 2nd GARDASIL vaccination here on 2/8/2007.


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