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This is VAERS ID 288904

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 288904
VAERS Form:
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''''s syndrome and /"other health issues/" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient di"d not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling /"flu like symptoms./" On 18-JUL


Changed on 12/8/2009

VAERS ID: 288904 Before After
VAERS Form:
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''''s Sjogren''s syndrome and /"other "other health issues/" issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient di"d did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling /"flu "flu like symptoms./" symptoms." On 18-JUL 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 288904 Before After
VAERS Form:(blank) 1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 288904 Before After
VAERS Form:1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 288904 Before After
VAERS Form:1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 288904 Before After
VAERS Form:1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 288904 Before After
VAERS Form:1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 288904 Before After
VAERS Form:1
Age:
Sex:Female
Location:Pennsylvania
Vaccinated:2007-06-04
Onset:2007-06-04
Submitted:2007-08-23
Entered:2007-08-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Headache, Influenza like illness, Malaise, Nausea, Pain, Pain in extremity, Pulmonary embolism, Vasculitis, Immediate post-injection reaction

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: Unknown
Current Illness: Sjogren''s syndrome; General symptom
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0708USA02491

Write-up: Information has been received from a female pharmacist who is also the patient with Sjogren''s syndrome and "other health issues" who on 04-JUN-2007 was vaccinated with a first dose of Gardasil. On 04-JUN-2007 immediately post vaccination the patient did not feel good and developed pain in her left arm, nausea, and headache. On an unspecified date the symptoms resolved. On 09-JUN-2007 and 10-JUN-2007 the patient felt sick, had pains in her legs and whole body, resembling "flu like symptoms." On 18-JUL-2007 the patient developed vasculitis in her right leg. On 04-AUG-2007 the patient was hospitalized with a diagnosis of, bilateral pulmonary embolism. She was treated with 5 mg of COUMADIN daily and 81 mg of Aspirin daily. On 10-AUG-2007 the patient was discharged from the hospital. At the time of the report the patient''s outcome was unknown. The reporting pharmacist considered the events to be other important medical events. Additional information has been requested.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=288904&WAYBACKHISTORY=ON


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