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This is VAERS ID 276634

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

276634
VAERS Form:
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-06
Onset:2007-04-07
Submitted:2007-04-13
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / - LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1030F / 1 LA / SC
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2689AA / 4 LA / IM

Administered by: Public      Purchased by: Unknown
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Hyperhidrosis

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Complete neurologic evaluation
CDC 'Split Type':

Write-up:High fever, difficulty breathing, hives, diaphoresis, chills, weakness with difficult ambulation, tachycardia, arm swollen twice it''''s normal size per patient report, racing heard and severe dizziness (no syncope). Dizziness persists.


Changed on 12/8/2009

276634 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-06
Onset:2007-04-07
Submitted:2007-04-13
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / - LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1030F / 1 LA / SC
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR C2689AA / 4 LA / IM

Administered by: Public      Purchased by: Unknown Public
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Hyperhidrosis, Oedema peripheral, Palpitations, Pyrexia, Tachycardia, Urticaria, Neurological examination

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Complete neurologic evaluation
CDC 'Split Type':

Write-up:High fever, difficulty breathing, hives, diaphoresis, chills, weakness with difficult ambulation, tachycardia, arm swollen twice it''''s it''s normal size per patient report, racing heard and severe dizziness (no syncope). Dizziness persists.


Changed on 5/14/2017

276634 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-06
Onset:2007-04-07
Submitted:2007-04-13
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / - LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1030F / 1 LA / SC
TDAP: TDAP (ADACEL) / AVENTIS PASTEUR SANOFI PASTEUR C2689AA / 4 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Hyperhidrosis, Oedema peripheral, Palpitations, Pyrexia, Tachycardia, Urticaria, Neurological examination

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Complete neurologic evaluation
CDC 'Split Type':

Write-up:High fever, difficulty breathing, hives, diaphoresis, chills, weakness with difficult ambulation, tachycardia, arm swollen twice it''s normal size per patient report, racing heard and severe dizziness (no syncope). Dizziness persists.


Changed on 9/14/2017

276634 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Oregon
Vaccinated:2007-04-06
Onset:2007-04-07
Submitted:2007-04-13
Entered:2007-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1425F / - UNK LA / IM
MMR: MEASLES + MUMPS + RUBELLA (MMR II) / MERCK & CO. INC. 1030F / 1 2 LA / SC
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2689AA / 4 5 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Chills, Dizziness, Dyspnoea, Hyperhidrosis, Oedema peripheral, Palpitations, Pyrexia, Tachycardia, Urticaria, Neurological examination

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
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: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Complete neurologic evaluation
CDC 'Split Type':

Write-up:High fever, difficulty breathing, hives, diaphoresis, chills, weakness with difficult ambulation, tachycardia, arm swollen twice it''s normal size per patient report, racing heard and severe dizziness (no syncope). Dizziness persists.


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