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This is VAERS ID 279291

Case Details

VAERS ID: 279291 (history)  
Form: Version 1.0  
Age: 17.0  
Gender: Female  
Location: Minnesota  
Vaccinated:2006-11-22
Onset:2006-11-22
   Days after vaccination:0
Submitted: 2007-05-22
   Days after onset:180
Entered: 2007-05-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR 62244AA / 1 RA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0688F / 1 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Gait disturbance, Nausea, Photophobia, Vomiting
SMQs:, Acute pancreatitis (broad), Peripheral neuropathy (broad), Anticholinergic syndrome (broad), Parkinson-like events (broad), Guillain-Barre syndrome (broad), Noninfectious meningitis (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Corneal disorders (broad), Retinal disorders (broad), Hypoglycaemia (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: ortho evra
Current Illness: uti
Preexisting Conditions: amoxicillin, latex allergies, recurrent uti''s
Allergies:
Diagnostic Lab Data: none, patient did not seek medical attention since it resolved on its own. She reported symptoms 5-22-07 when she presented to get her 3rd vaccination. 3rd shot not given.
CDC Split Type:

Write-up: generalized weakness, difficulty walking, photophobia, nausea. Started one hour after vaccine administered, lasted rest of day. Was gone the next morning. Occurred with first vaccine on 11-22-06 and with the second vaccine on 1-25-07. Also, after second vaccine only she vomitted one time.


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