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This is VAERS ID 278865

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 278865
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-01
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, St
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause"of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she de


Changed on 12/8/2009

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-01
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, St
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause"of cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she de developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


Changed on 4/13/2011

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-01 2007-03-02
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, St Strep A was neg.
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


Changed on 5/13/2011

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, Strep A was neg.
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


Changed on 6/11/2011

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, Strep A was neg.
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


Changed on 6/14/2014

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, Strep A was neg.
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


Changed on 2/14/2017

VAERS ID: 278865 Before After
Age:15.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-02
Onset:2007-03-02
Submitted:2007-05-17
Entered:2007-05-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1424F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Acute respiratory distress syndrome, Blood culture positive, Chest pain, Cough, Culture throat negative, Culture urine negative, Influenza, Multi-organ failure, Myalgia, Nasal congestion, Pharyngolaryngeal pain, Pneumonia staphylococcal, Pyrexia, Respiratory failure, Rhinorrhoea, Sepsis, Staphylococcal infection, Viral test, Streptococcus identification test, Mechanical ventilation

Life Threatening? Yes
Died? Yes
   Date died:2007-03-16
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 10     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Topamax
Current Illness:
Preexisting Conditions: PMH: migraine headaches. Family HX: younger sister also w/strep neg sore throat. Letter from school that group A strep infections present.
Diagnostic Lab Data: Influenza B isolated by viral culture. Specimen sent to CDC for antigenic characterization. LABS: Throat & urine c/s neg. Blood & endotrachael c/s + for MRSA. Nasal swab + for influ B virus. Lymph node c/s were neg. from PCP office, Strep A was neg.
CDC 'Split Type':

Write-up:Onset of symptoms on 3/1/07: fever, sore throat, cough, and myalgia. Respiratory failure on 3/6/07. 6/1/07 Received Death Certificate from epidemiologist which reveals COD asmultiorgan system failure and influenza B viral sepsis with contributing cause of staphyloccoccal secondary infection. Medical records included w/death certificate indicate patient was transferred to higher level of care on 3/6, was intubated & in PICU w/pneumonia & ARDS. Reportedly had been in good health until 3/1/07 when she developed sore throat, nasal congestion, rhinnorhea & low grade fever. COntinued to worsen & developed myalgias, chest pain & nonproductive cough w/higher fever. Seen by PCP on 3/5 & rapid strep was neg & dx was probable influenza. Sent home & developed nausea, vomiting & diarrhea as well as petechial rash over abdomen. Taken to outlying ER on 3/6 & found to be in respiratory failure, intubated & transferred to higher level of care. Respiratory status declined further & was placed on oscillator & ECMO. Peds ID consult done. Consult states had HPV vax at PCP on 3/2 & no other recent vaccines. 6/1/07 Received fax medical & vaccine records from CDC who had contacted provider. Reveals that on 1/2/07, patient received TDaP & HPV. On 3/2/07 received HPV #2. VAERS database updated w/same. On day of vax patient also dx w/right CTS, migraine HA, scoliosis. She was referred to Neuro & PT for the CTS & HA.


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