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This is VAERS ID 291286

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 291286
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 UN / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy
Preexisting Conditions: Concussion
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported
CDC 'Split Type':

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medicat"ion. On approximately 11-JUL-2007, /"soon after beginning therapy,/" the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with


Changed on 12/8/2009

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0525U / 0 UN RA / UN IM

Administered by: Other      Purchased by: Unknown Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with cl
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': (blank) WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medicat"ion. medication. On approximately 11-JUL-2007, /"soon "soon after beginning therapy,/" therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 1/5/2010

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with cl
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 8/31/2010

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with cl
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 1/4/2011

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with cl clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 4/13/2011

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 5/13/2011

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 6/11/2011

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 6/14/2014

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 4/14/2017

VAERS ID: 291286 Before After
VAERS Form:
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Arthralgia, Asthma, Back pain, Menstruation irregular, Migraine, Nuclear magnetic resonance imaging, Oral contraception, Ovarian cyst, Premenstrual syndrome, Pyrexia, Rhinitis allergic, Laboratory test, Diagnostic procedure

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: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 9/14/2017

VAERS ID: 291286 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 0 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 2/14/2018

VAERS ID: 291286 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 6/14/2018

VAERS ID: 291286 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 8/14/2018

VAERS ID: 291286 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 9/14/2018

VAERS ID: 291286 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.


Changed on 10/14/2018

VAERS ID: 291286 Before After
VAERS Form:1
Age:14.0
Sex:Female
Location:Arizona
Vaccinated:2007-07-11
Onset:2007-07-11
Submitted:2007-09-24
Entered:2007-09-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0525U / 1 RA / IM

Administered by: Other      Purchased by: Other
Symptoms: Migraine, Nuclear magnetic resonance imaging, Pyrexia, 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? Yes, days: 5     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications: None
Current Illness: Seasonal allergy 9/5/08-record received-8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping.
Preexisting Conditions: Concussion 9/5/08-records received-PMH:head injury 1/07.
Allergies:
Diagnostic Lab Data: magnetic resonance 09/04?/07 - not reported, diagnostic laboratory 09/04?/07 - not reported 9/5/08-records received-Normal GI series.
CDC 'Split Type': WAES0709USA02505

Write-up: Information has been received from a consumer concerning her 14 year old daughter with seasonal allergies and a history of concussion (January 2007) who on 11-JUL-2007 was vaccinated with the first 0.5 mL dose of Gardasil. There was no concomitant medication. On approximately 11-JUL-2007, "soon after beginning therapy," the patient experienced migraines and developed a low grade fever. On 28-AUG-2007 and 01-SEP-2007, the patient went to an emergency room. On 12-SEP-2007, the patient was vaccinated with the second 0.5 mL dose of Gardasil. The patient continued to experience migraines and a low grade fever. On 04-SEP-2007, the patient was hospitalized. On an unspecified date, magnetic resonance imaging (MRI) and unspecified blood work were performed on the patient. It was reported that the patient was hospitalized for a total of five days. At the time of this report, the patient''s migraines and low grade fever persisted. Additional information has been requested. 9/05/08-records received-routine office visit 7/11/07-C/O irregular periods, premenstrual symptoms and menstrual discomforts. Right and left hip pain.Moody. 8/8/07-C/O migraine headaches for 1-2 weeks. 8/07-continues to C/O bilateral hip pain for over a year intermittent in nature with clicking and popping. PE normal. 11/02/07-allergic rhinitis, headaches, asthma. 1/3/08-C/O abdominal pain. Headaches improved. 2/20/08-ovarian cyst, prescribed birth control pills. 4/5/08-C/O back pain.

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