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This is VAERS ID 646617

Case Details

VAERS ID: 646617 (history)  
Form: Version 1.0  
Age: 13.0  
Gender: Female  
Location: Colorado  
Vaccinated:2014-08-12
Onset:2015-03-01
   Days after vaccination:201
Submitted: 2016-08-05
   Days after onset:522
Entered: 2016-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H021346 / 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M12122 / 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B092FA / 1 LA / IM

Administered by: Public       Purchased by: Public
Symptoms: Asthenia, Fatigue, Headache, Immune thrombocytopenic purpura, Laboratory test abnormal
SMQs:, Haemorrhage terms (excl laboratory terms) (narrow), Guillain-Barre syndrome (broad), Hypersensitivity (narrow)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Abnormal
CDC Split Type:

Write-up: C/O headache increased fatigue, weakness. Developed Idiopathic thrombocytopenic purpura (ITP).


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