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This is VAERS ID 278478

Case Details

VAERS ID: 278478 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: California  
Vaccinated:2007-05-10
Onset:2007-05-11
   Days after vaccination:1
Submitted: 2007-05-14
   Days after onset:3
Entered: 2007-05-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB129AA / 2 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0181U / 2 RA / IM
IPV: POLIO VIRUS, INACT. (IPOL) / SANOFI PASTEUR Z0326-2 / 6 LA / IM
TDAP: TDAP (NO BRAND NAME) / UNKNOWN MANUFACTURER C2457AA / 2 LA / IM

Administered by: Unknown       Purchased by: Unknown
Symptoms: Diarrhoea, Pyrexia, Vomiting
SMQs:, Acute pancreatitis (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol, Benedryl, Hydrocortizone
Current Illness: Asthma
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: vomiting, diarrea, fever


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