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This is VAERS ID 397983

Case Details

VAERS ID:397983 (history)  Vaccinated:2010-07-16
Age:18.0  Onset:2010-08-20, Days after vaccination: 35
Gender:Male  Submitted:2010-09-12, Days after onset: 23
Location:Washington  Entered:2010-09-12
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Clindamycin Topical Solution
Current Illness: May not be correct on date administered, but am close. I was not ill at all at time of administration.
Preexisting Conditions: None; completely healthy.
Diagnostic Lab Data: urine test (all normal), test for mono (negative), colon not guarded, no inflammation of spleen or colon or appendix.
CDC 'Split Type':
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJUN
MEN: MENINGOCOCCAL (NO BRAND NAME)UNKNOWN MANUFACTURER 0IJUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 5IJUN
Administered by: Unknown     Purchased by: Other
Symptoms: Abdominal pain upper, Fatigue, Mononucleosis heterophile test negative, Urine analysis normal
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Extreme fatigue, spontaneous stomach pain (followed up with doctor and on 9/11/10 with ER - all blood work and urine confirmed no infection); the Gardasil vaccine was the only thing different that has occurred in my life. ER gave antispasm prescription and has sent me back to primary care doctor.

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