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This is VAERS ID 527628

Case Details

VAERS ID: 527628 (history)  
Age: 13.0  
Gender: Male  
Location: Pennsylvania  
Vaccinated:2011-10-03
Onset:2011-10-04
   Days after vaccination:1
Submitted: 2014-04-04
   Days after onset:913
Entered: 2014-04-04
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / SANOFI PASTEUR UH455AD / 0 UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1261AA / 0 UN / UN

Administered by: Private       Purchased by: Private
Symptoms: Asthenia, Fatigue, Headache, Myalgia
SMQs:, Rhabdomyolysis/myopathy (broad), Guillain-Barre syndrome (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 18 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Just recovered from Pnuemonia and was exposed to 2nd virus that gave him a headache and body aches 2 days before shot
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:

Write-up: Severe head pain, sore muscles, weak and tired.


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