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This is VAERS ID 278394

Case Details

VAERS ID: 278394 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Vermont  
Vaccinated:2007-05-08
Onset:2007-05-08
   Days after vaccination:0
Submitted: 2007-05-10
   Days after onset:2
Entered: 2007-05-11
   Days after submission:1
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B012AA / 1 LA / IM

Administered by: Private       Purchased by: Public
Symptoms: Abdominal pain upper, Asthenia, Body temperature increased, Chills, Ear pain, Erythema, Malaise, Nausea, Neck pain, Pain, Pallor
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Guillain-Barre syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypotonic-hyporesponsive episode (broad), Hypersensitivity (broad), Arthritis (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? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: PPD acne facial Rx products Clindamycin gel + Diff gel
Current Illness: none
Preexisting Conditions: Allergies-Ceclor, minocycline, benzyl peroxide
Allergies:
Diagnostic Lab Data: none
CDC Split Type:

Write-up: 5/8/07 Sleeping and woke up with chills and c/o neck pain and aches-$g Motrin 600 mg. 5/9/07 c/o nausea, stomachache, earaches T 102.4 deg at 3:00 pm Ears ok one red canal only per school nurse-ES Tylenol given and slept 3-4-07 pale and c/o weak and not feeling well. School nurse checked -$g adeq strength/BP 102/60 P72 no numbness/tingling All s/s resolved in pm.


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