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This is VAERS ID 274639

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274639
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-13
Onset:2007-03-17
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Headache, 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: Same symptoms~Human Papillomavirus Recombinant Vaccine, Quadrivalent (Gardasil)~1~19~In Patient
Other Medications: Seasonal (OCP),Novalog 1unit/20 gm carbs, Lantus 9 units @ HS, Zoloft 100mg.
Current Illness: Had been diag with Shingles on 3-5-07. Felt well at time of vaccination. T 98.0
Preexisting Conditions: IDDM onset 6-2005, Celiac Disease onset 7-06
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type': IDDM onset 6-2005, Celiac Disease onset 7-06

Write-up:Patient awoke during night with shakiness, headache, and vomited x''''s one 3 days after vaccination with second dose of Gardasil. Episode lasted approx one hour. Pt has IDDM, BS normal at that time. Same occurred after dose #1 which was reported as separat"e event.


Changed on 12/8/2009

274639 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-13
Onset:2007-03-17
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Headache, 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: Same symptoms~Human Papillomavirus Recombinant Vaccine, Quadrivalent (Gardasil)~1~19~In Patient
Other Medications: Seasonal (OCP),Novalog 1unit/20 gm carbs, Lantus 9 units @ HS, Zoloft 100mg.
Current Illness: Had been diag with Shingles on 3-5-07. Felt well at time of vaccination. T 98.0
Preexisting Conditions: IDDM onset 6-2005, Celiac Disease onset 7-06
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type': IDDM onset 6-2005, Celiac Disease onset 7-06

Write-up:Patient awoke during night with shakiness, headache, and vomited x''''s x''s one 3 days after vaccination with second dose of Gardasil. Episode lasted approx one hour. Pt has IDDM, BS normal at that time. Same occurred after dose #1 which was reported as separat"e separate event.


Changed on 10/14/2012

274639 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-13
Onset:2007-03-17
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, 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: Same symptoms~Human Papillomavirus Recombinant Vaccine, Quadrivalent (Gardasil)~1~19~In Patient
Other Medications: Seasonal (OCP),Novalog 1unit/20 gm carbs, Lantus 9 units @ HS, Zoloft 100mg.
Current Illness: Had been diag with Shingles on 3-5-07. Felt well at time of vaccination. T 98.0
Preexisting Conditions: IDDM onset 6-2005, Celiac Disease onset 7-06
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type': IDDM onset 6-2005, Celiac Disease onset 7-06 (blank)

Write-up:Patient awoke during night with shakiness, headache, and vomited x''s one 3 days after vaccination with second dose of Gardasil. Episode lasted approx one hour. Pt has IDDM, BS normal at that time. Same occurred after dose #1 which was reported as separate event.


Changed on 5/14/2017

274639 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-13
Onset:2007-03-17
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, 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: Same symptoms~Human Papillomavirus Recombinant Vaccine, Quadrivalent (Gardasil)~1~19~In symptoms~HPV (Gardasil)~1~19.20~In Patient
Other Medications: Seasonal (OCP),Novalog 1unit/20 gm carbs, Lantus 9 units @ HS, Zoloft 100mg.
Current Illness: Had been diag with Shingles on 3-5-07. Felt well at time of vaccination. T 98.0
Preexisting Conditions: IDDM onset 6-2005, Celiac Disease onset 7-06
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient awoke during night with shakiness, headache, and vomited x''s one 3 days after vaccination with second dose of Gardasil. Episode lasted approx one hour. Pt has IDDM, BS normal at that time. Same occurred after dose #1 which was reported as separate event.


Changed on 9/14/2017

274639 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Massachusetts
Vaccinated:2007-03-13
Onset:2007-03-17
Submitted:2007-03-23
Entered:2007-03-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Headache, 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: Same symptoms~HPV (Gardasil)~1~19.20~In Patient
Other Medications: Seasonal (OCP),Novalog 1unit/20 gm carbs, Lantus 9 units @ HS, Zoloft 100mg.
Current Illness: Had been diag with Shingles on 3-5-07. Felt well at time of vaccination. T 98.0
Preexisting Conditions: IDDM onset 6-2005, Celiac Disease onset 7-06
Allergies:
Diagnostic Lab Data: none
CDC 'Split Type':

Write-up:Patient awoke during night with shakiness, headache, and vomited x''s one 3 days after vaccination with second dose of Gardasil. Episode lasted approx one hour. Pt has IDDM, BS normal at that time. Same occurred after dose #1 which was reported as separate event.


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