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This is VAERS ID 278150

Case Details

VAERS ID: 278150 (history)  
Age: 15.0  
Gender: Female  
Location: New York  
Vaccinated:2007-03-22
Onset:2007-04-07
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2007-05-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0263U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UK2154CA / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Antinuclear antibody positive, Arthralgia, Headache, Hypoaesthesia, Joint swelling, Rash maculo-papular, Red blood cell sedimentation rate increased, Urticaria
SMQs:, Anaphylactic reaction (broad), Angioedema (narrow), Peripheral neuropathy (broad), Systemic lupus erythematosus (narrow), Guillain-Barre syndrome (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: No
Diagnostic Lab Data: 4/20 ESR = 126, C3 = 216, ANA; Positive (1:20) (4/24) = 258, JGE = 601.00, C4 = 51
CDC Split Type:

Write-up: (1) Headache. (2) Numbness on arms and legs, (3) Joint swelling and pain (Elbows, wrist, (4) Hives and Macucopapular rash on arms and legs. Menactra verified.


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