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This is VAERS ID 283980

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 283980
Age:
Gender:Female
Location:Unknown
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Malaise

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0705USA03075

Write-up:Information has been received from a physician concerning a female who was vaccinated with Gardasil. Subsequently the patient experienced significant malaise. The patient sought unspecified medical attention. Additional information has been requested.


Changed on 3/2/2010

VAERS ID: 283980 Before After
Age:(blank) 15.0
Gender:Female
Location:Unknown
Vaccinated:0000-00-00 2007-04-10
Onset:0000-00-00 2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0387U / - 0 UN / UN

Administered by: Other Private      Purchased by: Other Private
Symptoms: Malaise

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown Unknown; None
Diagnostic Lab Data: Unknown Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-react
CDC 'Split Type': WAES0705USA03075

Write-up:Information This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with Gardasil. Subsequently a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise. malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information has been requested. is not expected.


Changed on 4/7/2010

VAERS ID: 283980 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-10
Onset:2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Culture stool, Full blood count, Headache, Malaise, Rheumatoid factor, Weight decreased, Red blood cell sedimentation rate, Laboratory test, Bacterial test, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-react
CDC 'Split Type': WAES0705USA03075

Write-up:This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information is not expected.


Changed on 8/31/2010

VAERS ID: 283980 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-10
Onset:2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Culture stool, Full blood count, Headache, Malaise, Rheumatoid factor, Weight decreased, Red blood cell sedimentation rate, Laboratory test, Bacteria urine, Bacterial test, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-react
CDC 'Split Type': WAES0705USA03075

Write-up:This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information is not expected.


Changed on 1/4/2011

VAERS ID: 283980 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-10
Onset:2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Culture stool, Full blood count, Headache, Malaise, Rheumatoid factor, Weight decreased, Red blood cell sedimentation rate, Laboratory test, Bacteria urine, Bacterial test, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-react C-reactive protein, results not reported; serum TSH, results not reported; stool culture, results not reported; stool for ova and, results not reported; urine bacteria acream, results not reported; total serum thyroxine, results not reported
CDC 'Split Type': WAES0705USA03075

Write-up:This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information is not expected.


Changed on 6/14/2014

VAERS ID: 283980 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-10
Onset:2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Culture stool, Full blood count, Headache, Malaise, Rheumatoid factor, Weight decreased, Red blood cell sedimentation rate, Laboratory test, Bacterial test, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-reactive protein, results not reported; serum TSH, results not reported; stool culture, results not reported; stool for ova and, results not reported; urine bacteria acream, results not reported; total serum thyroxine, results not reported
CDC 'Split Type': WAES0705USA03075

Write-up:This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information is not expected.


Changed on 5/14/2017

VAERS ID: 283980 Before After
Age:15.0
Gender:Female
Location:Unknown
Vaccinated:2007-04-10
Onset:2007-04-22
Submitted:2007-06-14
Entered:2007-06-18
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0387U / 0 UN / UN

Administered by: Private      Purchased by: Private
Symptoms: Antinuclear antibody, Blood thyroid stimulating hormone, C-reactive protein, Chest pain, Culture stool, Full blood count, Headache, Malaise, Rheumatoid factor, Weight decreased, Red blood cell sedimentation rate, Laboratory test, Bacterial test, Oropharyngeal pain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown; None
Diagnostic Lab Data: Unknown; diagnostic laboratory, serum serotonin- results not reported; complete blood cell, result not reported; serum ANA, results not reported; serum rheumatoid factor, results not reported; erythrocyte, reults not reported; serum C-reactive protein, results not reported; serum TSH, results not reported; stool culture, results not reported; stool for ova and, results not reported; urine bacteria acream, results not reported; total serum thyroxine, results not reported
CDC 'Split Type': WAES0705USA03075

Write-up:This is in follow-up to report(s) previously submitted on 6/14/2007. Initial and follow-up information has been received from a physician concerning a 15 year old female student, with no pertinent medical history, who on 10-APR-2007 at 16:00, was vaccinated IM in the left arm with a first dose of GARDASIL (lot # 657621/0387U). On 22-APR-2007 at 17:00, the patient experienced significant malaise, sore throat, headache, chest pain, weight loss and nausea. The patient sought unspecified medical attention. Lab tests included complete blood cell count, serum antinuclear antibodies test, serum rheumatoid factor test, erythrocyte sedimentation rate, serum C-reactive protein test, total serum thyroxins test, serum thyroid-stimulating hormone test, stool culture test, serum serotonin, stool for ova and parasites, and urine culture (results not reported). At the time of the report, the symptoms were still present despite appropriate therapy- labs. Additional information is not expected.


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