National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 692487

Case Details

VAERS ID: 692487 (history)  
Form: Version 1.0  
Age: 10.0  
Gender: Female  
Location: California  
Vaccinated:2013-10-24
Onset:2013-10-24
   Days after vaccination:0
Submitted: 2017-04-26
   Days after onset:1280
Entered: 2017-04-28
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 74AP3 / 2 RA / IM

Administered by: Private       Purchased by: Other
Symptoms: Abdominal pain upper, Back pain, Headache, Laboratory test, Menorrhagia, Pelvic pain, Rash
SMQs:, Anaphylactic reaction (broad), Acute pancreatitis (broad), Haemorrhage terms (excl laboratory terms) (narrow), Retroperitoneal fibrosis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypersensitivity (narrow), Drug reaction with eosinophilia and systemic symptoms syndrome (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, ? days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Born with a tethered cord
Allergies:
Diagnostic Lab Data: Years of testing and hospitalization.
CDC Split Type:

Write-up: Headache day of vaccine and rash. Pain in her back, stomach, pelvis. Periods lasting weeks at a time and heavy. Back pain is constant.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=692487


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166