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This is VAERS ID 264204

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 264204
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-09-12
Onset:2006-09-13
Submitted:2006-09-22
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Coma, Mental impairment, Sinus arrhythmia, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium, Propanolol, Prozac, Seraguel, Clozapine, Ritalin, Aviane, Keflex.
Current Illness: NONE
Preexisting Conditions: Bipolar DS, ADHS, left hydronephrosis.
Diagnostic Lab Data: At ER 9/13/06 EKG sinus arrhythmia, chest X ray NL, CT head normal, CBC, U/A, Lytes and toxic screen neg NL.
CDC 'Split Type':

Write-up:09/13/06 pt went to school where she developed hives at 10am. She was sent home, mom came home and found pt unresponsive and called 911. Pt seen at ER. Became responsive and talking well at ER. Exam WNL. DX''''d changed mental status sent home.


Changed on 12/8/2009

VAERS ID: 264204 Before After
Age:15.0
Gender:Female
Location:Massachusetts
Vaccinated:2006-09-12
Onset:2006-09-13
Submitted:2006-09-22
Entered:2006-10-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0688F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Coma, Mental impairment, Sinus arrhythmia, Urticaria

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Lithium, Propanolol, Prozac, Seraguel, Clozapine, Ritalin, Aviane, Keflex.
Current Illness: NONE
Preexisting Conditions: Bipolar DS, ADHS, left hydronephrosis.
Diagnostic Lab Data: At ER 9/13/06 EKG sinus arrhythmia, chest X ray NL, CT head normal, CBC, U/A, Lytes and toxic screen neg NL.
CDC 'Split Type':

Write-up:09/13/06 pt went to school where she developed hives at 10am. She was sent home, mom came home and found pt unresponsive and called 911. Pt seen at ER. Became responsive and talking well at ER. Exam WNL. DX''''d DX''d changed mental status sent home.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=264204&WAYBACKHISTORY=ON


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