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This is VAERS ID 290580

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 290580
VAERS Form:
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Fatigue, Mental status changes

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type':

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (ma"nufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fa


Changed on 12/8/2009

VAERS ID: 290580 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 UN / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Fatigue, Mental status changes

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? Yes, days: 0     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': (blank) WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (ma"nufacturer (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fa fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 1/5/2010

VAERS ID: 290580 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 0 (blank)     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 9/14/2017

VAERS ID: 290580 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / - UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 2/14/2018

VAERS ID: 290580 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 6/14/2018

VAERS ID: 290580 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 8/14/2018

VAERS ID: 290580 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 9/14/2018

VAERS ID: 290580 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.


Changed on 10/14/2018

VAERS ID: 290580 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Unknown
Vaccinated:2007-05-16
Onset:2007-08-23
Submitted:2007-09-13
Entered:2007-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (NO BRAND NAME) / UNKNOWN MANUFACTURER - / UNK UN / UN
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0388U / 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Fatigue, Mental status changes

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:     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: Unknown
CDC 'Split Type': WAES0709USA00835

Write-up: Information has been received from a nurse concerning a 15 year old female who on 16-MAY-2007 was vaccinated with a first dose of Gardasil (lot 657622/0388U). On 16-MAY-2007, the patient was concomitantly vaccinated with hepatitis A vaccine (inactive) (manufacturer unknown). The nurse reported that the patient stated that she received a second dose of Gardasil, but the nurse noted that there was no documentation that the patient received a second dose of Gardasil. On 23-AUG-2007 the patient experienced fatigue, altered mental status and weakness. On 25-AUG-2007, the patient was brought to the emergency room. The patient was hospitalized (details and length of hospitalization not provided). The patient was visited by her physician on 25-AUG-2007, 26-AUG-2007, and 28-AUG-2007. At the time of this report, the outcome was unknown. Additional information has been requested.

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