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This is VAERS ID 552028

Case Details

VAERS ID: 552028 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: New York  
   Days after vaccination:38
Submitted: 2014-11-05
   Days after onset:96
Entered: 2014-11-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. J014218 / 1 LA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Abdominal pain upper, Blood test, Diarrhoea, Endoscopy, Haematochezia, Pain in extremity, Stool analysis, Urine analysis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Pseudomembranous colitis (broad), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad), Noninfectious diarrhoea (narrow), Tendinopathies and ligament disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: No
Preexisting Conditions: Allergic to Penicillin/Amoxicillin
Diagnostic Lab Data: Numerous tests done on blood, stool, urine. Endoscopy done.
CDC Split Type:

Write-up: Stomach pain, bloody stool, diarrhea up to 7 times a day, arm pain lasting for weeks.

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