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This is VAERS ID 278665

Case Details

VAERS ID: 278665 (history)  
Age: 12.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2007-03-13
Onset:2007-04-08
   Days after vaccination:26
Submitted: 2007-05-15
   Days after onset:37
Entered: 2007-05-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
DTAP: DTAP (DAPTACEL) / SANOFI PASTEUR C2688AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1427F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2108AA / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Diarrhoea, Fatigue, Headache, Malaise, Nausea, Vomiting, Wrong drug administered
SMQs:, Acute pancreatitis (broad), Pseudomembranous colitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Noninfectious diarrhoea (narrow), Medication errors (narrow)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data:
CDC Split Type:

Write-up: ILLNESS WITH HEADACHE, NAUSEA, VOMITING DIARRHEA AND FATIGUE FROM 4/8/07 - 4/13/07; RECEIVED GARDASIL VACCINATION ON 3/13/07; NO TREATMENT


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