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This is VAERS ID 290364

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 290364
VAERS Form:
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / UN

Administered by: Private      Purchased by: Unknown
Symptoms: Anxiety, Hypomania, Insomnia, Mental status changes, 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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 12/8/2009

VAERS ID: 290364 Before After
VAERS Form:
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 LA / UN

Administered by: Private      Purchased by: Unknown Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 9/14/2017

VAERS ID: 290364 Before After
VAERS Form:(blank) 1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 0 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 2/14/2018

VAERS ID: 290364 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 6/14/2018

VAERS ID: 290364 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 8/14/2018

VAERS ID: 290364 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 9/14/2018

VAERS ID: 290364 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.


Changed on 10/14/2018

VAERS ID: 290364 Before After
VAERS Form:1
Age:13.0
Sex:Female
Location:New Mexico
Vaccinated:2007-08-13
Onset:2007-08-13
Submitted:2007-08-30
Entered:2007-09-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0389U / 1 LA / UN

Administered by: Private      Purchased by: Other
Symptoms: Anxiety, Hypomania, Insomnia, Mood altered, Nuclear magnetic resonance imaging normal, Panic attack, Mental status changes, Laboratory test, Psychotic disorder

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:
Current Illness: None
Preexisting Conditions: Allergy to penicillin, seasonal allergies
Allergies:
Diagnostic Lab Data: Neg. lab test, neg. MRI
CDC 'Split Type':

Write-up: Sudden onset insomnia, hypomania, anxiety and panic attacks followed by 5 days of psychosis with mental status change.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=290364&WAYBACKHISTORY=ON


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