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Case Details (Sorted by Age)

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VAERS ID:602761 (history)  Vaccinated:2015-10-15
Age:12.0  Onset:2015-10-15, Days after vaccination: 0
Gender:Male  Submitted:2015-10-15, Days after onset: 0
Location:Idaho  Entered:2015-10-15
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU4: INFLUENZA (SEASONAL) (FLUZONE QUADRIVALENT)SANOFI PASTEURU1444AA0IMRA
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0164280IMLA
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO)NOVARTIS VACCINES AND DIAGNOSTICSM150320IMRA
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALS2224P0IMLA
VARCEL: VARICELLA (VARIVAX)MERCK & CO. INC.L0004561SCLA
Administered by: Private     Purchased by: Public
Symptoms: Hypotonia, Lethargy, Syncope
SMQs:, Torsade de pointes/QT prolongation (broad), Peripheral neuropathy (broad), Arrhythmia related investigations, signs and symptoms (broad), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad)
Write-up: Pt. had an episode of syncope which lasted only a few seconds after administration of final vaccine HPV 9. Pt. was alert and orientated. Pt. given juice and cool cloths. Pt. laid down. After pt. a few min. pt. retained color. Pt. then began to become very lethargic for about 30 min. Pt. would respond to name and open eyes. Pt.s body noted to be limp. After approx. 1 hour in office pt. was still not completely functional.

VAERS ID:603183 (history)  Vaccinated:2015-10-14
Age:12.0  Onset:2015-10-14, Days after vaccination: 0
Gender:Male  Submitted:2015-10-16, Days after onset: 2
Location:Florida  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (FLUZONE)SANOFI PASTEURU5309BA2IMLA
HPV4: HPV (GARDASIL)MERCK & CO. INC.K0102150IMRA
Administered by: Private     Purchased by: Public
Symptoms: Chills, Fatigue, Headache, Limb discomfort, Vomiting
SMQs:, Acute pancreatitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow)
Write-up: Arm felt heavy in few hours after. Few hours (1-2) cold, shivers, 1 emesis, fell asleep, next day low grade headache, fatigue, slept all day. Normal d #3.

VAERS ID:603223 (history)  Vaccinated:2015-10-08
Age:12.0  Onset:2015-10-09, Days after vaccination: 1
Gender:Female  Submitted:2015-10-16, Days after onset: 7
Location:California  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations: 10/09/2015~Influenza (Seasonal) (FluMist)~UN~9.00~Sibling
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.FJ21590IN 
Administered by: Private     Purchased by: Private
Symptoms: Cough, Lacrimation increased, Rhinorrhoea
SMQs:, Anaphylactic reaction (broad), Lacrimal disorders (narrow)
Write-up: The next evening after receiving the FLUMIST began having sxs cough runny nose, watery eyes.

VAERS ID:604916 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006339
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:604989 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006345
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605001 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006347
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605009 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006355
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605034 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006367
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605041 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006363
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605050 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006372
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to an 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported. No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605054 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006371
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to an 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported. No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605066 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006360
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to an 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported. No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605073 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006385
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:605074 (history)  Vaccinated:0000-00-00
Age:12.0  Onset:0000-00-00
Gender:Unknown  Submitted:2015-10-16
Location:Unknown  Entered:2015-10-16
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Diagnostic Lab Data:
CDC Split Type: WAES1510USA006381
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC.  UNUN
Administered by: Other     Purchased by: Other
Symptoms: Incorrect product storage, No adverse event
SMQs:
Write-up: This spontaneous report as received from a certified medical assistant to a 12 year old patient of an unknown gender. The patients'' medical history, concurrent conditions and concomitant medications were not reported. Approximately in 2015 (reported as 27-AUG-2015 to 03-SEP-2015) the patient was vaccinated with improperly stored dose of GARDASIL (lot # K010215 with expiration date 05-MAY-2017 or lot # K011562 with expiration date 08-APR-2017; dose and route of administration were not reported). No adverse experiences were reported. This is one of the several reports received from same reporter. Additional information has been requested.

VAERS ID:603475 (history)  Vaccinated:2015-10-15
Age:12.0  Onset:2015-10-18, Days after vaccination: 3
Gender:Male  Submitted:2015-10-19, Days after onset: 1
Location:Montana  Entered:2015-10-19
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: None
Diagnostic Lab Data: No
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLUN4: INFLUENZA (SEASONAL) (FLUMIST QUADRIVALENT)MEDIMMUNE VACCINES, INC.FJ21890IN 
TDAP: TDAP (BOOSTRIX)GLAXOSMITHKLINE BIOLOGICALSB4SD90IMLA
Administered by: Public     Purchased by: Private
Symptoms: Headache, Nasal congestion, Oropharyngeal pain, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow)
Write-up: Rec''d LAIV on 10/15/15, developed stuffy nose. 10/18/15 developed sore throat, headache, fever 104. Fever approximately 101 with MOTRIN. Is taking fluids okay.

VAERS ID:603430 (history)  Vaccinated:2011-04-21
Age:12.0  Onset:2011-04-28, Days after vaccination: 7
Gender:Female  Submitted:2015-10-19, Days after onset: 1635
Location:California  Entered:2015-10-20, Days after submission: 1
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: No
Preexisting Conditions: No
Diagnostic Lab Data: After several months - years of laser light therapy, she never recovered. It is an auto immune disease, so I doubt she ever will. The white spots still remain and she still has skin problems to this day. Very sensitive skin ever since the immunization.
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV4: HPV (GARDASIL)MERCK & CO. INC. 1UNUN
TDAP: TDAP (NO BRAND NAME)UNKNOWN MANUFACTURER 5UNUN
Administered by: Private     Purchased by: Private
Symptoms: Autoimmune disorder, Hyperaesthesia, Skin exfoliation, Sunburn, Vitiligo
SMQs:, Severe cutaneous adverse reactions (broad), Accidents and injuries (narrow), Hypersensitivity (broad)
Write-up: Got an unusual sunburn on her face while at school - which burned really easily. When it peeled. Underneath was pure white skin. She was then sent to dermatology, when she was later (October 26, 2011) diagnosed with auto immune disease Vitiligo. She went through about a year or 2 of laser light therapy to get rid of it and it never got better. The doctors were baffled as to how she could get it as there is absolutely NO family history of Vitiligo. They said that it was not normal for her to get such a thing and that she didn''t match any of the characteristics relating to getting this. Since then she has to stay out of the sun or she burns and blisters. She has very extra sensitive skin ever since.

VAERS ID:604336 (history)  Vaccinated:2015-10-21
Age:12.0  Onset:2015-10-21, Days after vaccination: 0
Gender:Female  Submitted:2015-10-23, Days after onset: 2
Location:Texas  Entered:2015-10-23
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Zoloft 25 mg per day
Current Illness: No
Preexisting Conditions: ADHD
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEUR 0IMLA
Administered by: Private     Purchased by: Private
Symptoms: Fatigue, Headache, Malaise, Pyrexia
SMQs:, Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad)
Write-up: Headache, fever, malaise, fatigue.

VAERS ID:604575 (history)  Vaccinated:2015-10-19
Age:12.0  Onset:2015-10-21, Days after vaccination: 2
Gender:Male  Submitted:2015-10-24, Days after onset: 3
Location:Washington  Entered:2015-10-24
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: Albuterol HFA 108 (90) Base MCG/ACT INHALATION AEROSOL SOLUTION
Current Illness: Recovering from common cold. (Started 2 weeks prior.)
Preexisting Conditions: Exercise-indused asthma.
Diagnostic Lab Data:
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
FLU3: INFLUENZA (SEASONAL) (NO BRAND NAME)UNKNOWN MANUFACTURER   LA
Administered by: Private     Purchased by: Other
Symptoms: Chills, Feeling cold, Immediate post-injection reaction, Musculoskeletal disorder, Pain in extremity, Pyrexia
SMQs:, Rhabdomyolysis/myopathy (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Hypersensitivity (narrow), Tendinopathies and ligament disorders (broad)
Write-up: He felt very cold, shivering, felt too cold to walk. He was in a warm room at school at the time. His rectal temperature at about 3:45 PM was 101*. At 4:30 PM it was 103.2*. It was 99* at 10:00 PM. By the next morning, there was no fever and no more symptoms. In addition, his arm hurt badly enough immediately after getting the flu shot that he didn''t use it for the rest of the first day.

VAERS ID:604641 (history)  Vaccinated:2015-10-22
Age:12.0  Onset:2015-10-23, Days after vaccination: 1
Gender:Male  Submitted:2015-10-26, Days after onset: 3
Location:North Dakota  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Diagnostic Lab Data: None
CDC Split Type: ND1511
Vaccination
Manufacturer
Lot
Dose
Route
Site
HEPA: HEP A (NO BRAND NAME)UNKNOWN MANUFACTURER 1IMLA
HPVX: HPV (NO BRAND NAME)UNKNOWN MANUFACTURER 2IMRA
Administered by: Public     Purchased by: Other
Symptoms: Injection site erythema, Injection site pain, Injection site reaction, Injection site swelling, Injection site warmth, Skin tightness
SMQs:, Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow)
Write-up: Right deltoid swollen, red, hot to touch; skin very tight and sore, tender to touch-- today 10/24/2015 area is approx 6 in x 3 in involved. Started about 15-20 hrs after immunize, got worse on 10/25 in AM. Skin loosened some late afternoon.

VAERS ID:604911 (history)  Vaccinated:2015-10-26
Age:12.0  Onset:2015-10-26, Days after vaccination: 0
Gender:Female  Submitted:2015-10-26, Days after onset: 0
Location:Michigan  Entered:2015-10-26
Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: NONE
Preexisting Conditions: NONE
Diagnostic Lab Data: NONE
CDC Split Type:
Vaccination
Manufacturer
Lot
Dose
Route
Site
HPV9: HPV (GARDASIL 9)MERCK & CO. INC.L0134291IMRA
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA)SANOFI PASTEURU5172BA1IMLA
Administered by: Public     Purchased by: Public
Symptoms: Immediate post-injection reaction, Loss of consciousness
SMQs:, Torsade de pointes/QT prolongation (broad), Hyperglycaemia/new onset diabetes mellitus (broad), Neuroleptic malignant syndrome (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Noninfectious encephalitis (broad), Noninfectious encephalopathy/delirium (broad), Noninfectious meningitis (broad), Hypotonic-hyporesponsive episode (broad), Generalised convulsive seizures following immunisation (broad), Hypersensitivity (narrow)
Write-up: Immediately following injection of HPV - 9, patient loss consciousness/slumped in chair for approximately 15 seconds. Recovered spontaneously.

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