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This is VAERS ID 281089

Case Details

VAERS ID: 281089 (history)  
Age: 12.0  
Gender: Female  
Location: Ohio  
Vaccinated:2007-06-04
Onset:2007-06-04
   Days after vaccination:0
Submitted: 2007-06-04
   Days after onset:0
Entered: 2007-06-08
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B013AA / 0 LA / IM

Administered by: Private       Purchased by: Private
Symptoms: Decreased appetite, Flushing, Full blood count, Muscular weakness, Nausea, Pain, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Guillain-Barre syndrome (broad), Noninfectious encephalopathy/delirium (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zithromax, Diflucan
Current Illness: otitis yeast infection
Preexisting Conditions: Amoxicillin
Diagnostic Lab Data: CBC w/diff (awaiting results)
CDC Split Type:

Write-up: fever (102.F), flushed cheeks, leg/arm pain, weakness in legs, nausea, poor appetite x 2 days


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