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This is VAERS ID 281114

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

281114
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-04-24
Onset:2007-05-03
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Activated partial thromboplastin time prolonged, Anaemia, Antiphospholipid syndrome, C-reactive protein increased, Complement factor C3

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: None
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC (anemia), CBP (elevated), Sed rate, C3, Cy Total Complemax, Lupus panel (abnormal), Rheum factor ANA, Doppler studies x2 of lower extremities negative for clots. records received 6/27/07-Increased ESR and CRP and normocytic anemia. Inc
CDC 'Split Type':

Write-up:Patient present to office for eval of swollen ankles beginning 5/3/07. Bloodwork showed mild anemia and abnormal coagulation panel. Patient further complained of swelling, numbness to Right feet and daily headaches. Negative Doppler studies x2 for clots i"n legs. Patient received Garadasil #2 & Tdap vaccine 4/24/07. Patient had normal CBC in 2/07. Patient now seeing hematogolist. 6/27/07-records received for DOS 4/23-5/21/07-Bilateral ankle edema, foot pain headaches. HX running track. On 5/21/07-Edema re


Changed on 12/8/2009

281114 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-04-24
Onset:2007-05-03
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Activated partial thromboplastin time prolonged, Anaemia, Antiphospholipid syndrome, C-reactive protein increased, Full blood count, Headache, Hypoaesthesia, International normalised ratio, Joint swelling, Normochromic normocytic anaemia, Prothrombin level increased, Rheumatoid factor, Ultrasound Doppler, Ultrasound Doppler normal, Red blood cell sedimentation rate increased, Complement factor C3, Laboratory test, X-ray limb normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: None
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC (anemia), CBP (elevated), Sed rate, C3, Cy Total Complemax, Lupus panel (abnormal), Rheum factor ANA, Doppler studies x2 of lower extremities negative for clots. records received 6/27/07-Increased ESR and CRP and normocytic anemia. Inc
CDC 'Split Type':

Write-up:Patient present to office for eval of swollen ankles beginning 5/3/07. Bloodwork showed mild anemia and abnormal coagulation panel. Patient further complained of swelling, numbness to Right feet and daily headaches. Negative Doppler studies x2 for clots i"n in legs. Patient received Garadasil #2 & Tdap vaccine 4/24/07. Patient had normal CBC in 2/07. Patient now seeing hematogolist. 6/27/07-records received for DOS 4/23-5/21/07-Bilateral ankle edema, foot pain headaches. HX running track. On 5/21/07-Edema re resolved. Residual right foot numbness. No fever or swelling for 3 days. Antiphospholid syndrome. To see hem/onc for anemia.


Changed on 5/14/2017

281114 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-04-24
Onset:2007-05-03
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Activated partial thromboplastin time prolonged, Anaemia, Antiphospholipid syndrome, C-reactive protein increased, Full blood count, Headache, Hypoaesthesia, International normalised ratio, Joint swelling, Normochromic normocytic anaemia, Prothrombin level increased, Rheumatoid factor, Ultrasound Doppler, Ultrasound Doppler normal, Red blood cell sedimentation rate increased, Complement factor C3, Laboratory test, X-ray limb normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: None
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC (anemia), CBP (elevated), Sed rate, C3, Cy Total Complemax, Lupus panel (abnormal), Rheum factor ANA, Doppler studies x2 of lower extremities negative for clots. records received 6/27/07-Increased ESR and CRP and normocytic anemia. Inc Increased PT, PTT and decreased INR. Lyme disease negative. X-ray feet negative. Lower extremity Duplex scan negative.
CDC 'Split Type':

Write-up:Patient present to office for eval of swollen ankles beginning 5/3/07. Bloodwork showed mild anemia and abnormal coagulation panel. Patient further complained of swelling, numbness to Right feet and daily headaches. Negative Doppler studies x2 for clots in legs. Patient received Garadasil #2 & Tdap vaccine 4/24/07. Patient had normal CBC in 2/07. Patient now seeing hematogolist. 6/27/07-records received for DOS 4/23-5/21/07-Bilateral ankle edema, foot pain headaches. HX running track. On 5/21/07-Edema resolved. Residual right foot numbness. No fever or swelling for 3 days. Antiphospholid syndrome. To see hem/onc for anemia.


Changed on 9/14/2017

281114 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:New York
Vaccinated:2007-04-24
Onset:2007-05-03
Submitted:2007-06-05
Entered:2007-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0384U / 1 2 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C2644AA / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Anaemia, C-reactive protein increased, Full blood count, Headache, Hypoaesthesia, Joint swelling, Rheumatoid factor, Ultrasound Doppler, Red blood cell sedimentation rate increased, Complement factor C3, Laboratory test

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Minocycline
Current Illness: None
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC (anemia), CBP (elevated), Sed rate, C3, Cy Total Complemax, Lupus panel (abnormal), Rheum factor ANA, Doppler studies x2 of lower extremities negative for clots. records received 6/27/07-Increased ESR and CRP and normocytic anemia. Increased PT, PTT and decreased INR. Lyme disease negative. X-ray feet negative. Lower extremity Duplex scan negative.
CDC 'Split Type':

Write-up:Patient present to office for eval of swollen ankles beginning 5/3/07. Bloodwork showed mild anemia and abnormal coagulation panel. Patient further complained of swelling, numbness to Right feet and daily headaches. Negative Doppler studies x2 for clots in legs. Patient received Garadasil #2 & Tdap vaccine 4/24/07. Patient had normal CBC in 2/07. Patient now seeing hematogolist. 6/27/07-records received for DOS 4/23-5/21/07-Bilateral ankle edema, foot pain headaches. HX running track. On 5/21/07-Edema resolved. Residual right foot numbness. No fever or swelling for 3 days. Antiphospholid syndrome. To see hem/onc for anemia.


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