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This is VAERS ID 275310

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

275310
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Unknown
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Influenza serology negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 12/8/2009

275310 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Unknown Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 3/2/2010

275310 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 4/7/2010

275310 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 6/14/2014

275310 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 5/14/2017

275310 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR A17714A / 0 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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


Changed on 9/14/2017

275310 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Florida
Vaccinated:2007-03-13
Onset:2007-03-14
Submitted:2007-03-30
Entered:2007-03-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 1 - / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR A17714A / 0 1 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain, Chills, Dizziness, Headache, Pharyngolaryngeal pain, Pyrexia, Vomiting, Influenza serology negative, Streptococcus identification test negative

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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: Left Choroidal fissure brain cyst - stable in size
Allergies:
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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