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This is VAERS ID 276302

Case Details

VAERS ID: 276302 (history)  
Age: 11.0  
Gender: Female  
Location: California  
Vaccinated:2007-04-12
Onset:2007-04-12
   Days after vaccination:0
Submitted: 2007-04-13
   Days after onset:1
Entered: 2007-04-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0244U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2158AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B009AA / 0 RL / IM

Administered by: Other       Purchased by: Unknown
Symptoms: Body temperature increased, Headache, Physical examination, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: Temp 99 no other illnesses
Preexisting Conditions: none
Diagnostic Lab Data: physical exam 4/13/07 with flu scheduled
CDC Split Type:

Write-up: approx 1 hour after vaccine pt reported headache with temp (had tem 99 deg) per pt mom tem up to 102 approx 4 hour after I 25-vomiting approx 2 hour after I 25


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