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This is VAERS ID 631134

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

VAERS ID: 631134
VAERS Form:
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 2 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 0 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 9/14/2017

VAERS ID: 631134 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 2 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 2/14/2018

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 6/14/2018

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 8/14/2018

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 9/14/2018

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 10/14/2018

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 12/24/2020

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 12/30/2020

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 5/7/2021

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.


Changed on 5/21/2021

VAERS ID: 631134 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:California
Vaccinated:2016-04-01
Onset:2016-04-01
Submitted:2016-04-05
Entered:2016-04-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. L024993 / 3 RA / IM
MENB: MENINGOCOCCAL B (TRUMENBA) / PFIZER/WYETH M37314 / 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Headache, Injection site pain, Pain, Urinary tract infection, Vomiting, White blood cells urine positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: MOTRIN; CLARITIN; FLONASE
Current Illness: Eczema; Allergy rhinitis; Temp 99.0
Preexisting Conditions: Panic attack Allergy rhinitis; Eczma
Allergies:
Diagnostic Lab Data: UA - bacteria few, leukocytes 3+ oer mother labs drawn and UA in ER (+) UTI 4/2/16
CDC 'Split Type':

Write-up: Generalised pain, particularly increase pain at injectable site, vomiting, headache.

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