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This is VAERS ID 650279

Case Details

VAERS ID: 650279 (history)  
Form: Version 1.0  
Age: 15.0  
Gender: Female  
Location: New York  
Vaccinated:2015-07-20
Onset:2015-10-31
   Days after vaccination:103
Submitted: 2016-08-31
   Days after onset:305
Entered: 2016-08-31
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (VAQTA) / MERCK & CO. INC. L009445 / UNK LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K016966 / 1 RA / IM

Administered by: Unknown       Purchased by: Private
Symptoms: Abdominal distension, Abdominal pain, Colitis ulcerative, Colonoscopy, Culture stool, Enema administration, Full blood count, Laboratory test, Nuclear magnetic resonance imaging abdominal, Rectal discharge, Rectal haemorrhage, Stool analysis
SMQs:, Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal ulceration (narrow), Gastrointestinal haemorrhage (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Ischaemic colitis (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
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: Colonoscopy, MRI of abdomen, stool analysis and culture, CBC, GI analysis
CDC Split Type:

Write-up: Blood and mucus from rectum, abdominal cramping, bloating and pain. Diagnosed with ulcerative colitis and is currently on hydrocortisone enemas qd, Melamine rectal suspension qd and Pentasa 500mg two capsules by mouth three times daily.


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