This is VAERS ID 289177

(NOTE: This result is from the 12/31/2007 version of the VAERS database)

Case Details

VAERS ID:	289177 (history)
Form:	Version .0
Age:	18.0
Sex:	Female
Location:	Florida

Vaccinated:	2007-08-23
Onset:	2007-08-23
Days after vaccination:	0
Submitted:	2007-08-27
Days after onset:	4
Entered:	2007-08-28
Days after submission:	1

Vaccination / Manufacturer	Lot / Dose	Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC.	1060U / 0	RA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / SANOFI PASTEUR	U2381BA / 0	RA / IM

Administered by: Private Purchased by: Unknown
Symptoms: Back pain, Blood culture negative, Blood pressure, CSF cell count normal, CSF culture negative
SMQs:, Retroperitoneal fibrosis (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None
CDC Split Type:

Write-up: severe headache at night time after vaccination; exacerbated in the next morning, photophobia, entire body ache, chills, trouble breathing, low grade fever 100.3. On exam BP 150/78 shaking but nonconvulsive, transferred to hospital via ambulance. 1 day ad"mission, spinal tap has r/o meningitis done-normal. Persistent headache few days after discharge

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https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20071231&IDNUMBER=289177