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This is VAERS ID 274128

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274128
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / - - / -

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain, Arthralgia, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative

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: UNK
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06
CDC 'Split Type':

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menac"tra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pac


Changed on 12/8/2009

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-01
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (NO BRAND NAME) INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - / -
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR - / - - / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNK
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negati
CDC 'Split Type': (blank) WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menac"tra. Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pac Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and sh


Changed on 1/5/2010

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-01 2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - - UN / - UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR - / - - UN / - UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNK UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negati
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and sh


Changed on 4/7/2010

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Computerised tomogram normal, Decreased activity, Diarrhoea, Headache, Mononucleosis heterophile test negative, Nausea, Nuclear magnetic resonance imaging normal, Paraesthesia, Sinusitis, Vomiting, Bacterial test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negati
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and sh


Changed on 8/31/2010

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Computerised tomogram normal, Decreased activity, Diarrhoea, Headache, Mononucleosis heterophile test negative, Nausea, Nuclear magnetic resonance imaging normal, Paraesthesia, Sinusitis, Ultrasound kidney normal, Vomiting, Bacterial test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negati
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and sh


Changed on 1/4/2011

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Computerised tomogram normal, Decreased activity, Diarrhoea, Headache, Mononucleosis heterophile test negative, Nausea, Nuclear magnetic resonance imaging normal, Paraesthesia, Sinusitis, Ultrasound kidney normal, Vomiting, Bacterial test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negati negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and sh she did not have pain or vomiting.


Changed on 4/13/2011

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 5/13/2011

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 6/11/2011

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 7/7/2013

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 6/14/2014

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 7/14/2015

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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 Yes, days: (blank) 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 12/14/2016

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 2/14/2017

274128 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain, Arthralgia, Computerised tomogram normal, Culture stool negative, Decreased activity, Diarrhoea, Dyspnoea, Dysuria, Headache, Liver function test abnormal, Mononucleosis heterophile test negative, Nausea, Neck pain, Nuclear magnetic resonance imaging normal, Pain in extremity, Paraesthesia, Sinusitis, Ultrasound Doppler, Ultrasound kidney normal, Vision blurred, Vomiting, X-ray with contrast upper gastrointestinal tract, Ultrasound abdomen normal, Epigastric discomfort, Blood human chorionic gonadotropin normal, Borrelia burgdorferi serology negative, Bacterial test negative, Streptococcus identification test negative

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


Changed on 9/14/2017

274128 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Unknown
Vaccinated:2006-12-01
Onset:2006-12-08
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLUX: INFLUENZA (SEASONAL) (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Computerised tomogram normal, Decreased activity, Diarrhoea, Headache, Mononucleosis heterophile test negative, Nausea, Nuclear magnetic resonance imaging normal, Paraesthesia, Sinusitis, Vomiting, Bacterial test negative

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: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNKNOWN
Current Illness:
Preexisting Conditions: UNKNOWN
Allergies:
Diagnostic Lab Data: computed axial, 12/06; magnetic resonance, 12/06 records received 5/1/07-MRI negative, lab work normal. CT head and MRI of head negative. Normal abdominal ultrasound. Doppler normal of kidneys, normal upper GI series. negative lyme, negative beta HCG. Normal stool cultures. Strep culture negative.
CDC 'Split Type': WAES0702USA00866

Write-up:Information has been received from a pharmacy student concerning a 16 year old female who on December 2006, was vaccinated IM with a first 0.5 ml dose of HPV. Concomitant therapy included given the same day included a dose of influenza and a dose of Menactra. Seven days after vaccination, the patient experienced headache, nausea, vomiting and diarrhea. The patient was treated with Nexium and Phenergan tablets/suppositories. On 13-DEC-2006 the patient experienced a sinus infection and was placed on a Z-pack. All symptoms resolved except the headache. On 19-JAN-2007, the patient was seen by a neurologist and was placed on Prednisone for 10 days. He also ordered Tazepam to help her sleep since the headaches were keeping her awake and Endocet for the headache pain. The patient has missed a lot of school and is sedentary. She was also complaining of tingling in the hands and legs. The following tests have come back negative: CAT scan, MRI, Lyme and "mono" workup. At the time of this report, the patient had not recovered from tingling in the hands and legs and headache. No product quality complaint as involved. Additional information has been requested. 04/10/07-records received from neurologists for DOS 2/6/07-DX: muscular headaches with some functional overlay. Doubt side effect of Gardasil. C/O headaches, back pain, GI problems recent urinary symptoms, difficulty urinating and dysuria. C/O visual symptoms including blurry vision and spots before her eyes. PE: pain in neck, pain with deep palpation of right popliteal fossa. Walks normally. 05/01/07-records received from facility for DOS 02/09-02/12/07-DC DX: Vomiting and Abdominal Pain. HX 2month of chronic somatic complaints including nausea, epigastric discomfort, diffuse soft tissue and joint pain, vomiting, periodic shortness of breath and recent urinary symptoms. Labs, liver enzymes elevated in context of multiple Tylenol usage as an outpatient due to her pain.Hospital course included discontinuance of Tylenol and Percocet. LFTs steadily trended downward and she did not have pain or vomiting.


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