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This is VAERS ID 278268

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

278268
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-05-08
Entered:2007-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blood culture negative, Computerised tomogram normal, CSF culture negative, Culture urine negative, CSF test normal

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: diagnostic laboratory 04/25/07 - negative
CDC 'Split Type':

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient who on 24-APR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hepatitis A virus vaccine (manufacturer u"nspecified), PedvaxHib and Menactra. On 25-APR-2007, the day following the vaccinations, the patient returned to the office with complaints of groin pain; blood work (unspecified) testing was performed, and was negative. On 30-APR-2007 the patient experie


Changed on 12/8/2009

278268 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-05-08
Entered:2007-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blood culture negative, Computerised tomogram normal, CSF culture negative, Culture urine negative, Groin pain, Headache, Herpes zoster, Meningitis viral, Nausea, Photosensitivity reaction, Rash, Laboratory test normal, CSF test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No 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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: hemolytic uremic syndrome requiring hospitalization & blood transfusions out of country, shingles 4/24/07. right wrist tendon injury & fracture of growth plate.
Allergies:
Diagnostic Lab Data: diagnostic laboratory 04/25/07 - negative LABS: WBC 4.4, AST 43, Mag 2.5. CK 292, MBs neg. CSF WBC 55, RBC 10, lymphs 86, monos 14, protein 28, glucose 44, pleocytosis of CSF. CSF herpes & VZ was neg. Blood & urine c/s neg. CT of head
CDC 'Split Type': (blank) WAES0705USA00797

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient who on 24-APR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hepatitis A virus vaccine (manufacturer u"nspecified), unspecified), PedvaxHib and Menactra. On 25-APR-2007, the day following the vaccinations, the patient returned to the office with complaints of groin pain; blood work (unspecified) testing was performed, and was negative. On 30-APR-2007 the patient experie experienced a headache and a rash on her leg, and again returned to the physician''s office; the patient was diagnosed with zoster, and was given Tylenol and codeine for treatment of the symptoms. On 03-MAY-2007, the patient presented that the patient may have viral meningitis. At the time of this report, the physician reported that the patient may have viral meningitis. At the time of this report, the patient had not recovered from the events. Additional information has been requested. 5/18/2007 Received medical records from hospital which reveal patient experienced shingles, severe HA which continued to worsen, photosensitivity, nausea. Opthal exam prior to admit was WNL. Admitted 5/3-5/6/07. ID consult obtained. Treated w/IV antibiotics & antivirals. Symptoms resolved day after treatment started & patient continued to progress well. D/C home on no meds w/close outpatient PCP f/u. FINAL DX: meninigitis, presumed viral (aseptic), final c/s pending; HA, resolved; herpes zoster right leg suspected. 6/8/07 Received note from PCP stating CSF PCRs for HSV & entervirus were neg. Also included name of admitting physician at hospital where PCP does not have privileges.


Changed on 4/7/2010

278268 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-05-08
Entered:2007-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blood culture negative, Computerised tomogram normal, CSF culture negative, Culture urine negative, Groin pain, Headache, Herpes zoster, Meningitis viral, Nausea, Photosensitivity reaction, Rash, Laboratory test normal, CSF test normal

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: hemolytic uremic syndrome requiring hospitalization & blood transfusions out of country, shingles 4/24/07. right wrist tendon injury & fracture of growth plate.
Allergies:
Diagnostic Lab Data: diagnostic laboratory 04/25/07 - negative LABS: WBC 4.4, AST 43, Mag 2.5. CK 292, MBs neg. CSF WBC 55, RBC 10, lymphs 86, monos 14, protein 28, glucose 44, pleocytosis of CSF. CSF herpes & VZ was neg. Blood & urine c/s neg. CT of head
CDC 'Split Type': WAES0705USA00797

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient who on 24-APR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hepatitis A virus vaccine (manufacturer unspecified), PedvaxHib and Menactra. On 25-APR-2007, the day following the vaccinations, the patient returned to the office with complaints of groin pain; blood work (unspecified) testing was performed, and was negative. On 30-APR-2007 the patient experienced a headache and a rash on her leg, and again returned to the physician''s office; the patient was diagnosed with zoster, and was given Tylenol and codeine for treatment of the symptoms. On 03-MAY-2007, the patient presented that the patient may have viral meningitis. At the time of this report, the physician reported that the patient may have viral meningitis. At the time of this report, the patient had not recovered from the events. Additional information has been requested. 5/18/2007 Received medical records from hospital which reveal patient experienced shingles, severe HA which continued to worsen, photosensitivity, nausea. Opthal exam prior to admit was WNL. Admitted 5/3-5/6/07. ID consult obtained. Treated w/IV antibiotics & antivirals. Symptoms resolved day after treatment started & patient continued to progress well. D/C home on no meds w/close outpatient PCP f/u. FINAL DX: meninigitis, presumed viral (aseptic), final c/s pending; HA, resolved; herpes zoster right leg suspected. 6/8/07 Received note from PCP stating CSF PCRs for HSV & entervirus were neg. Also included name of admitting physician at hospital where PCP does not have privileges.


Changed on 2/14/2017

278268 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-05-08
Entered:2007-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Blood culture negative, Computerised tomogram normal, CSF culture negative, Culture urine negative, Groin pain, Headache, Herpes zoster, Meningitis viral, Nausea, Photosensitivity reaction, Rash, Laboratory test normal, CSF test normal

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: hemolytic uremic syndrome requiring hospitalization & blood transfusions out of country, shingles 4/24/07. right wrist tendon injury & fracture of growth plate.
Allergies:
Diagnostic Lab Data: diagnostic laboratory 04/25/07 - negative LABS: WBC 4.4, AST 43, Mag 2.5. CK 292, MBs neg. CSF WBC 55, RBC 10, lymphs 86, monos 14, protein 28, glucose 44, pleocytosis of CSF. CSF herpes & VZ was neg. Blood & urine c/s neg. CT of head was WNL.
CDC 'Split Type': WAES0705USA00797

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient who on 24-APR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hepatitis A virus vaccine (manufacturer unspecified), PedvaxHib and Menactra. On 25-APR-2007, the day following the vaccinations, the patient returned to the office with complaints of groin pain; blood work (unspecified) testing was performed, and was negative. On 30-APR-2007 the patient experienced a headache and a rash on her leg, and again returned to the physician''s office; the patient was diagnosed with zoster, and was given Tylenol and codeine for treatment of the symptoms. On 03-MAY-2007, the patient presented that the patient may have viral meningitis. At the time of this report, the physician reported that the patient may have viral meningitis. At the time of this report, the patient had not recovered from the events. Additional information has been requested. 5/18/2007 Received medical records from hospital which reveal patient experienced shingles, severe HA which continued to worsen, photosensitivity, nausea. Opthal exam prior to admit was WNL. Admitted 5/3-5/6/07. ID consult obtained. Treated w/IV antibiotics & antivirals. Symptoms resolved day after treatment started & patient continued to progress well. D/C home on no meds w/close outpatient PCP f/u. FINAL DX: meninigitis, presumed viral (aseptic), final c/s pending; HA, resolved; herpes zoster right leg suspected. 6/8/07 Received note from PCP stating CSF PCRs for HSV & entervirus were neg. Also included name of admitting physician at hospital where PCP does not have privileges.


Changed on 9/14/2017

278268 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-04-24
Onset:2007-04-25
Submitted:2007-05-08
Entered:2007-05-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UNK UN / UN
HIBV: HIB (PEDVAXHIB) / MERCK & CO. INC. - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR - / - UNK UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Groin pain, Headache, Herpes zoster, Meningitis viral, Rash, Laboratory test normal

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? Yes
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown PMH: hemolytic uremic syndrome requiring hospitalization & blood transfusions out of country, shingles 4/24/07. right wrist tendon injury & fracture of growth plate.
Allergies:
Diagnostic Lab Data: diagnostic laboratory 04/25/07 - negative LABS: WBC 4.4, AST 43, Mag 2.5. CK 292, MBs neg. CSF WBC 55, RBC 10, lymphs 86, monos 14, protein 28, glucose 44, pleocytosis of CSF. CSF herpes & VZ was neg. Blood & urine c/s neg. CT of head was WNL.
CDC 'Split Type': WAES0705USA00797

Write-up:Information has been received from a physician, via a company representative, concerning a 12 year old female patient who on 24-APR-2007 was vaccinated with the first dose of Gardasil. Concomitant therapy included hepatitis A virus vaccine (manufacturer unspecified), PedvaxHib and Menactra. On 25-APR-2007, the day following the vaccinations, the patient returned to the office with complaints of groin pain; blood work (unspecified) testing was performed, and was negative. On 30-APR-2007 the patient experienced a headache and a rash on her leg, and again returned to the physician''s office; the patient was diagnosed with zoster, and was given Tylenol and codeine for treatment of the symptoms. On 03-MAY-2007, the patient presented that the patient may have viral meningitis. At the time of this report, the physician reported that the patient may have viral meningitis. At the time of this report, the patient had not recovered from the events. Additional information has been requested. 5/18/2007 Received medical records from hospital which reveal patient experienced shingles, severe HA which continued to worsen, photosensitivity, nausea. Opthal exam prior to admit was WNL. Admitted 5/3-5/6/07. ID consult obtained. Treated w/IV antibiotics & antivirals. Symptoms resolved day after treatment started & patient continued to progress well. D/C home on no meds w/close outpatient PCP f/u. FINAL DX: meninigitis, presumed viral (aseptic), final c/s pending; HA, resolved; herpes zoster right leg suspected. 6/8/07 Received note from PCP stating CSF PCRs for HSV & entervirus were neg. Also included name of admitting physician at hospital where PCP does not have privileges.


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