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This is VAERS ID 289290

(NOTE: This result is from the 6/14/2018 version of the VAERS database)

Case Details

VAERS ID: 289290 (history)  
Form: Version 1.0  
Age: 17.0  
Sex: Female  
Location: Pennsylvania  
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted: 2007-08-14
Entered: 2007-08-16
   Days after submission:2
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other       Purchased by: Other
Symptoms: Appendicitis
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC Split Type: WAES0707USA02026

Write-up: Information has been received from a physician''s assistant (PA), via a company representative, regarding a 17 year old female patient, who "months ago" was vaccinated with the first dose of Gardasil (Lot # not provided). The day following the vaccination, she developed appendicitis and was hospitalized (dates and duration not reported). At the time of this report, the patient was recovering from the event. Additional information has been requested.


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Link To This Search Result:

https://www.medalerts.org/vaersdb/findfield.php?SNAPSHOT=20180614&IDNUMBER=289290


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