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This is VAERS ID 274638

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274638
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-11
Onset:2007-01-16
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Dizziness, Herpes zoster, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonale(OCP), Novalog 1unit/20gm carbs, Lantus 9units @HS, Zoloft 100mg
Current Illness: Viral pharyngitis and ear pain at time of injection. T 98.7
Preexisting Conditions: IDDM onset 6-2005, Celiac Sprue 7-2006
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient states awoke during night with trembling, dizziness, vomiting x''''s 1 approx 5 days after injection#1. Pt with IDDM, BS elevated at that time. Episode lasted approx two hours. Also with similar complaints after Injection #2, will report as separate"event. Of note, pt diagnosed with Shingles on 3-5-07.


Changed on 12/8/2009

274638 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-11
Onset:2007-01-16
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Dizziness, Herpes zoster, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonale(OCP), Novalog 1unit/20gm carbs, Lantus 9units @HS, Zoloft 100mg
Current Illness: Viral pharyngitis and ear pain at time of injection. T 98.7
Preexisting Conditions: IDDM onset 6-2005, Celiac Sprue 7-2006
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient states awoke during night with trembling, dizziness, vomiting x''''s x''s 1 approx 5 days after injection#1. Pt with IDDM, BS elevated at that time. Episode lasted approx two hours. Also with similar complaints after Injection #2, will report as separate"event. separate event. Of note, pt diagnosed with Shingles on 3-5-07.


Changed on 9/14/2017

274638 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-01-11
Onset:2007-01-16
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0961F / 0 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Dizziness, Herpes zoster, Tremor, Vomiting

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Seasonale(OCP), Novalog 1unit/20gm carbs, Lantus 9units @HS, Zoloft 100mg
Current Illness: Viral pharyngitis and ear pain at time of injection. T 98.7
Preexisting Conditions: IDDM onset 6-2005, Celiac Sprue 7-2006
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient states awoke during night with trembling, dizziness, vomiting x''s 1 approx 5 days after injection#1. Pt with IDDM, BS elevated at that time. Episode lasted approx two hours. Also with similar complaints after Injection #2, will report as separate event. Of note, pt diagnosed with Shingles on 3-5-07.


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