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This is VAERS ID 607052

Case Details

VAERS ID: 607052 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Illinois  
Vaccinated:2013-10-31
Onset:0000-00-00
Submitted: 2015-11-03
Entered: 2015-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020901 / 3 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4556AB / 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0505M / 1 UN / UN

Administered by: Public       Purchased by: Private
Symptoms: Complex regional pain syndrome, Impaired gastric emptying, Postural orthostatic tachycardia syndrome
SMQs:, Gastrointestinal obstruction (narrow), Gastrointestinal nonspecific dysfunction (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? Yes, 17 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: VSD, asthma
Allergies:
Diagnostic Lab Data: Having an EEG and gastric emptying study
CDC Split Type:

Write-up: Developed CRPS, POTS, gastroparesis ongoing.


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