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This is VAERS ID 284902

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

284902
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-18
Onset:2007-05-19
Submitted:2007-07-06
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain lower, Computerised tomogram normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Computed axial 05/19/07 - normal
CDC 'Split Type':

Write-up:Information has been received from a physician concerning an /"18 year old/" female who on 18-MAY-2007 who on 18-MAY-2007 was vaccinated IM in her left arm with Gardasil. Concomitant therapy included VAQTA and BOOSTRIX. On 19-MAY-2007 the patient experien"ced severe lower right abdominal pain. The patient sought medical attention at the hospital and had a CT Scan performed. It was reported the CT Scan was normal and the patient was not admitted to the hospital. Subsequently, the patient recovered from seve


Changed on 12/8/2009

284902 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-18
Onset:2007-05-19
Submitted:2007-07-06
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain lower, Computerised tomogram normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Computed axial 05/19/07 - normal
CDC 'Split Type': (blank) WAES0706USA00252

Write-up:Information has been received from a physician concerning an /"18 "18 year old/" old" female who on 18-MAY-2007 who on 18-MAY-2007 was vaccinated IM in her left arm with Gardasil. Concomitant therapy included VAQTA and BOOSTRIX. On 19-MAY-2007 the patient experien"ced experienced severe lower right abdominal pain. The patient sought medical attention at the hospital and had a CT Scan performed. It was reported the CT Scan was normal and the patient was not admitted to the hospital. Subsequently, the patient recovered from seve severe lower right abdominal pain. Additional information has been requested.


Changed on 9/14/2017

284902 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Unknown
Vaccinated:2007-05-18
Onset:2007-05-19
Submitted:2007-07-06
Entered:2007-07-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. - / - UNK UN / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS - / - UNK UN / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain lower, Computerised tomogram normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Computed axial 05/19/07 - normal
CDC 'Split Type': WAES0706USA00252

Write-up:Information has been received from a physician concerning an "18 year old" female who on 18-MAY-2007 who on 18-MAY-2007 was vaccinated IM in her left arm with Gardasil. Concomitant therapy included VAQTA and BOOSTRIX. On 19-MAY-2007 the patient experienced severe lower right abdominal pain. The patient sought medical attention at the hospital and had a CT Scan performed. It was reported the CT Scan was normal and the patient was not admitted to the hospital. Subsequently, the patient recovered from severe lower right abdominal pain. Additional information has been requested.


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