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This is VAERS ID 289177

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 289177
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2381BA / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Back pain, Blood culture negative, Blood pressure, CSF cell count normal, CSF culture negative

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day ad"mission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge


Changed on 12/8/2009

VAERS ID: 289177 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR U2381BA / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Back pain, Blood culture negative, Blood pressure, Chills, Computerised tomogram normal, Condition aggravated, CSF cell count normal, CSF culture negative, Culture urine negative, Dyspnoea, Echocardiogram normal, Full blood count, Headache, Lumbar puncture, Pain, Pharyngolaryngeal pain, Photophobia, Pyrexia, Tremor, Metabolic function test 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day ad"mission, admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 4/7/2010

VAERS ID: 289177 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 0 RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Blood culture negative, Blood pressure, Chills, Computerised tomogram normal, Condition aggravated, CSF cell count normal, CSF culture negative, Culture urine negative, Dyspnoea, Echocardiogram normal, Full blood count, Headache, Lumbar puncture, Pain, Pharyngolaryngeal pain, Photophobia, Pyrexia, Tremor, Metabolic function test 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 5/14/2017

VAERS ID: 289177 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 0 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Back pain, Blood culture negative, Blood pressure, Chills, Computerised tomogram normal, Condition aggravated, CSF cell count normal, CSF culture negative, Culture urine negative, Dyspnoea, Echocardiogram normal, Full blood count, Headache, Lumbar puncture, Pain, Pharyngolaryngeal pain, Photophobia, Pyrexia, Tremor, Metabolic function test 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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 9/14/2017

VAERS ID: 289177 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 2/14/2018

VAERS ID: 289177 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 6/14/2018

VAERS ID: 289177 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 8/14/2018

VAERS ID: 289177 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 9/14/2018

VAERS ID: 289177 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.


Changed on 10/14/2018

VAERS ID: 289177 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:Florida
Vaccinated:2007-08-23
Onset:2007-08-23
Submitted:2007-08-27
Entered:2007-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1060U / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2381BA / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood pressure, Chills, Condition aggravated, Dyspnoea, Headache, Lumbar puncture, Pain, Photophobia, Pyrexia, Tremor

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? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None records received 9/19/07- CBC unremarkable, BMP also unremarkable, spinal tap within normal limits and culture negative.. Throat culture negative. Blood and urine cultures negative. Echo demonstrated left peripheral pylmonic stenosis benign in nature. CT brain unremarkable.
CDC 'Split Type':

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day admission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge 9/19/07-records received for DOS /24-/26/07- DC DX: Probable reaction to meningococcal vaccination. Meningitis has been ruled out. Headache and back pain now stable. Headache and back pain is thought to be due to probable reaction to meningococcal vaccination and probably from the spinal tap also. C/O headache and photophobia. Fever of 103 and sore throat for past 24 hours. Associated neck stiffness and pain.

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