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This is VAERS ID 460291

Case Details

VAERS ID: 460291 (history)  
Form: Version 1.0  
Age: 18.0  
Sex: Male  
Location: Texas  
Vaccinated:2012-07-16
Onset:2012-07-19
   Days after vaccination:3
Submitted: 2012-07-26
   Days after onset:7
Entered: 2012-07-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0636AE / 1 RA / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M11047 / 2 LA / UN

Administered by: Private       Purchased by: Unknown
Symptoms: Small intestinal obstruction
SMQs:, Gastrointestinal obstruction (narrow)

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? Yes, 7 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Age 3 - ruptured appendix; 5/2004 Adhesive bowel obstruction; 6/2004 Bilateral hydroceles; 10/2006 Osgood-Schlatter (L) knee
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Child rec''d HPV#1 & MENVEO on 7-16-12 - was fine when left office. On 7-19-12 presented ER - Dx: small bowel obstruction.


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