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This is VAERS ID 282927

Case Details

VAERS ID: 282927 (history)  
Age: 16.0  
Gender: Female  
Location: South Carolina  
Vaccinated:2007-06-26
Onset:2007-06-26
   Days after vaccination:0
Submitted: 2007-06-27
   Days after onset:1
Entered: 2007-06-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0515U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR UE518AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B006BA / 0 RA / IM

Administered by: Private       Purchased by: Private
Symptoms: Haematuria, Urine analysis abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Motrin and Tylenol
Current Illness: none
Preexisting Conditions: thyroglossal cyst and inguinal hernias as a child
Diagnostic Lab Data: none done
CDC Split Type:

Write-up: Apparent Hematuria (pink-red urine) approximately 6 hours after administration of 3 vaccines. Continued through the evening, tea-colored urine in morning and then cleared. No other symptoms noted. NOrmal UA at the exam earlier in the day.


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