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This is VAERS ID 283531

Case Details

VAERS ID: 283531 (history)  
Form: Version 1.0  
Age: 18.0  
Gender: Female  
Location: Massachusetts  
Vaccinated:2007-06-15
Onset:2007-06-16
   Days after vaccination:1
Submitted: 2007-06-27
   Days after onset:11
Entered: 2007-07-02
   Days after submission:5
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0522U / 1 LA / -
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2278AA / 1 LA / -

Administered by: Private       Purchased by: Unknown
Symptoms: Anxiety, Culture throat negative, Nausea, Palpitations, Pharyngolaryngeal pain
SMQs:, Acute pancreatitis (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Avian
Current Illness:
Preexisting Conditions: Anxiety D/O, obesity
Allergies:
Diagnostic Lab Data: Throat culture - neg
CDC Split Type:

Write-up: Sore throat, palpitations, nausea, anxiety


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