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This is VAERS ID 595387

Case Details

VAERS ID: 595387 (history)  
Form: Version 1.0  
Age: 16.0  
Sex: Female  
Location: Connecticut  
Vaccinated:2015-09-10
Onset:2015-09-12
   Days after vaccination:2
Submitted: 2015-09-15
   Days after onset:3
Entered: 2015-09-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV9: HPV (GARDASIL 9) / MERCK & CO. INC. L011846 / UNK RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH J29203 / UNK LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U5058AD / 2 RA / IM

Administered by: Unknown       Purchased by: Other
Symptoms: Chills, Culture urine negative, Full blood count normal, Haematuria, Metabolic function test normal, Nausea, Pregnancy test negative, Red blood cells urine positive, Ultrasound kidney normal, Ultrasound pelvis normal
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Chronic kidney disease (broad), Tubulointerstitial diseases (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: CBC, CMP - WNL; Serum pregnancy test - negative; Microscopic U/A - 50+ RBCs; Urine Culture - negative; Kidney and pelvic Ultrasound - WNL
CDC Split Type:

Write-up: Patient has nausea, chills x 48 hours after vaccines. Then the morning of 9/12, patient developed gross hematuria.


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