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This is VAERS ID 275310

Case Details

VAERS ID: 275310 (history)  
Form: Version 1.0  
Age: 12.0  
Gender: Female  
Location: Florida  
   Days after vaccination:1
Submitted: 2007-03-30
   Days after onset:16
Entered: 2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 1 - / -

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Influenza serology negative, Pharyngolaryngeal pain, Pyrexia, Streptococcus identification test negative, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Diagnostic Lab Data: Rapid Strep test (-), rapid influenza test (-)
CDC Split Type:

Write-up: Received Gardasil and Menactra on same day 3/13/07 at a routine physician. Approximately 12 hours later, she began with fevers, chills, headache, dizziness, sore throat & abdominal pain, vomited x 1

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