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This is VAERS ID 582524

Case Details

VAERS ID: 582524 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Male  
Location: Rhode Island  
Vaccinated:2015-03-23
Onset:2015-04-02
   Days after vaccination:10
Submitted: 2015-06-20
   Days after onset:79
Entered: 2015-06-20
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS C7392 / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007828 / 1 UN / UN

Administered by: Private       Purchased by: Other
Symptoms: Contusion, Malaise, Petechiae
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Accidents and injuries (narrow)

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? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Doxcycline for acne
Current Illness: There were no illness at time of vaccine
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data:
CDC Split Type:

Write-up: Patient was going to Dr. as he had not been feeling well. When we got there, he was covered in bruising and petechia.


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