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This is VAERS ID 283525

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

283525
VAERS Form:
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2006-10-16
Onset:2006-10-28
Submitted:2007-03-30
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 06040F / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Blood creatinine increased, Blood follicle stimulating hormone abnormal, Blood urea increased, Colonoscopy abnormal, Weight decreased

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? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Provera, Yasmin
Current Illness: Amenorrhea
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: See Endocrinologist, Gastroenterologist
CDC 'Split Type':

Write-up:The patient was an athlete in peak condition. She was being treated for amenorrhea in Aug 2006 with PROVERA followed by YASMIN at the time of the first administration of Gardasil. After 10/16/06 administration of Gardasil she dropped from 120 lbs to 88 lb"s by 1/15/07. She was hospitalized 2/14/07 for one week. Her condition was never diagnosed. Unexplained weight loss.


Changed on 12/8/2009

283525 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2006-10-16
Onset:2006-10-28
Submitted:2007-03-30
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 06040F / 1 LA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Blood creatinine increased, Blood follicle stimulating hormone abnormal, Blood urea increased, Colonoscopy abnormal, Weight decreased

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? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Provera, Yasmin
Current Illness: Amenorrhea
Preexisting Conditions: none 10/18/07-PMH: significant for endocrime and gynecological evaluation and follow up due to amenorrhea and since then in 2005 patient has been treated with oral contraception.
Allergies:
Diagnostic Lab Data: See Endocrinologist, Gastroenterologist 10/18/07-records received-Colonoscopy 2/9/07 revealed colonic focal cryptitis. Creatinine 1.1, BUN 20. MRI brain pineal gland cysts. Follicle stimulating hormone increased.
CDC 'Split Type':

Write-up:The patient was an athlete in peak condition. She was being treated for amenorrhea in Aug 2006 with PROVERA followed by YASMIN at the time of the first administration of Gardasil. After 10/16/06 administration of Gardasil she dropped from 120 lbs to 88 lb"s lbs by 1/15/07. She was hospitalized 2/14/07 for one week. Her condition was never diagnosed. Unexplained weight loss. 10/18/07-records received for DOS 2/12-2/26/07- DC DX: Weight Loss. Absence of Menstruation. 30 pound weight loss since October 2006, denies appetite changes. No nausea no vomiting, no abdominal pain, no headache. Denies being depressed. Stopped taking pills in September 2006 and has had no periods since that day.


Changed on 2/14/2017

283525 Before After
VAERS Form:
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2006-10-16
Onset:2006-10-28
Submitted:2007-03-30
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 06040F / 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatinine increased, Blood follicle stimulating hormone abnormal, Blood urea increased, Colonoscopy abnormal, Weight decreased

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? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Provera, Yasmin
Current Illness: Amenorrhea
Preexisting Conditions: none 10/18/07-PMH: significant for endocrime and gynecological evaluation and follow up due to amenorrhea and since then in 2005 patient has been treated with oral contraception.
Allergies:
Diagnostic Lab Data: See Endocrinologist, Gastroenterologist 10/18/07-records received-Colonoscopy 2/9/07 revealed colonic focal cryptitis. Creatinine 1.1, BUN 20. MRI brain pineal gland cysts. Follicle stimulating hormone increased.
CDC 'Split Type':

Write-up:The patient was an athlete in peak condition. She was being treated for amenorrhea in Aug 2006 with PROVERA followed by YASMIN at the time of the first administration of Gardasil. After 10/16/06 administration of Gardasil she dropped from 120 lbs to 88 lbs by 1/15/07. She was hospitalized 2/14/07 for one week. Her condition was never diagnosed. Unexplained weight loss. 10/18/07-records received for DOS 2/12-2/26/07- DC DX: Weight Loss. Absence of Menstruation. 30 pound weight loss since October 2006, denies appetite changes. No nausea no vomiting, no abdominal pain, no headache. Denies being depressed. Stopped taking pills in September 2006 and has had no periods since that day.


Changed on 9/14/2017

283525 Before After
VAERS Form:(blank) 1
Age:18.0
Gender:Female
Location:Florida
Vaccinated:2006-10-16
Onset:2006-10-28
Submitted:2007-03-30
Entered:2007-07-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 06040F / 1 2 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Weight decreased

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? Yes, days: 14     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Provera, Yasmin
Current Illness: Amenorrhea
Preexisting Conditions: none 10/18/07-PMH: significant for endocrime and gynecological evaluation and follow up due to amenorrhea and since then in 2005 patient has been treated with oral contraception.
Allergies:
Diagnostic Lab Data: See Endocrinologist, Gastroenterologist 10/18/07-records received-Colonoscopy 2/9/07 revealed colonic focal cryptitis. Creatinine 1.1, BUN 20. MRI brain pineal gland cysts. Follicle stimulating hormone increased.
CDC 'Split Type':

Write-up:The patient was an athlete in peak condition. She was being treated for amenorrhea in Aug 2006 with PROVERA followed by YASMIN at the time of the first administration of Gardasil. After 10/16/06 administration of Gardasil she dropped from 120 lbs to 88 lbs by 1/15/07. She was hospitalized 2/14/07 for one week. Her condition was never diagnosed. Unexplained weight loss. 10/18/07-records received for DOS 2/12-2/26/07- DC DX: Weight Loss. Absence of Menstruation. 30 pound weight loss since October 2006, denies appetite changes. No nausea no vomiting, no abdominal pain, no headache. Denies being depressed. Stopped taking pills in September 2006 and has had no periods since that day.


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