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This is VAERS ID 532207

Case Details

VAERS ID: 532207 (history)  
Age: 11.0  
Gender: Male  
Location: New Mexico  
Vaccinated:2013-04-30
Onset:2013-06-18
   Days after vaccination:49
Submitted: 2014-05-28
   Days after onset:344
Entered: 2014-05-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0638AE / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4261AA / 0 LA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B092DA / 0 RA / UN

Administered by: Private       Purchased by: Other
Symptoms: Arthralgia, Groin pain, Imaging procedure, Joint swelling, Nerve block, Rash, Tenderness, Weight bearing difficulty
SMQs:, Anaphylactic reaction (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Osteonecrosis (broad), Hypersensitivity (narrow), Arthritis (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 21 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: FOOD Allergies: tomatoes, pineapple, apples; MEDICATION Allergies: Augmentin, Bacterium, tetanus, PCN, pertussis, Cipro, morphine; Mitrial and tricuspid insufficient
Diagnostic Lab Data:
CDC Split Type:

Write-up: RT hip and groin pain, unable to bear weight. Unable to touch right hip or leg. Swelling and rash to hip region. Patient was placed in the hospital for 3 weeks (6/24/13-6/26-13, 7/8/2013-7/11/2013, 7/23/2013-7/26/2013- 1st hospital) (9/11/20103-9/14/2013- 2nd hospital). Seen a number of physicians for hip and groin pain- had a number of medical images- had a nerve block x2. Did Physical therapy for a number of months- both land and water therapy. Tried HBO therapy.


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