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This is VAERS ID 278996

Case Details

VAERS ID: 278996 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: New York  
Vaccinated:2007-03-13
Onset:2007-03-14
   Days after vaccination:1
Submitted: 2007-05-18
   Days after onset:65
Entered: 2007-05-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 1 RA / -

Administered by: Private       Purchased by: Private
Symptoms: Abdominal pain upper
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)

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:
Current Illness:
Preexisting Conditions: Mild asthma, sinus allergies (Environmental)
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient stated she had stomach pain x 3 weeks after 1st Gardasil Imm.


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