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This is VAERS ID 570682

History of Changes from the VAERS Wayback Machine

First Appeared on 4/14/2015

VAERS ID: 570682
VAERS Form:
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 0 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


Changed on 9/14/2017

VAERS ID: 570682 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 0 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


Changed on 2/14/2018

VAERS ID: 570682 Before After
VAERS Form:1
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


Changed on 6/14/2018

VAERS ID: 570682 Before After
VAERS Form:1
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


Changed on 8/14/2018

VAERS ID: 570682 Before After
VAERS Form:1
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.


Changed on 9/14/2018

VAERS ID: 570682 Before After
VAERS Form:1
Age:16.0
Gender:Unknown
Location:Vermont
Vaccinated:2015-03-04
Onset:2015-03-04
Submitted:0000-00-00
Entered:2015-03-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K007264 / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4986AA / 1 LA / IM

Administered by: Private      Purchased by: Public
Symptoms: Abdominal pain, Back pain, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: US and O2 Sat checked
CDC 'Split Type':

Write-up: Returned to office with abdominal pain - Rt leg numbness and Rt back pain - resolved after resting 40 min.

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