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This is VAERS ID 291485

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 291485
VAERS Form:
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 2 GM / UN

Administered by: Other      Purchased by: Unknown
Symptoms: Blood culture negative, Computerised tomogram abnormal, Cough, Dysphagia, Aspiration biopsy

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

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose o"f Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested.


Changed on 12/8/2009

VAERS ID: 291485 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 2 GM / UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Blood culture negative, Computerised tomogram abnormal, Cough, Dysphagia, Epstein-Barr virus infection, Facial pain, Fatigue, Haemoptysis, Local swelling, Lymphadenitis, Mononucleosis heterophile test positive, Parotitis, Red man syndrome, Sinusitis, Red blood cell sedimentation rate increased, Aspiration biopsy, Rheumatoid factor increased, Epstein-Barr virus test positive

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph n
CDC 'Split Type': (blank) WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose o"f of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 2/14/2017

VAERS ID: 291485 Before After
VAERS Form:
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 2 GM / UN

Administered by: Other      Purchased by: Other
Symptoms: Blood culture negative, Computerised tomogram abnormal, Cough, Dysphagia, Epstein-Barr virus infection, Facial pain, Fatigue, Haemoptysis, Local swelling, Lymphadenitis, Mononucleosis heterophile test positive, Parotitis, Red man syndrome, Sinusitis, Red blood cell sedimentation rate increased, Aspiration biopsy, Rheumatoid factor increased, Epstein-Barr virus test positive

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph n nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 9/14/2017

VAERS ID: 291485 Before After
VAERS Form:(blank) 1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 2 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 2/14/2018

VAERS ID: 291485 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 6/14/2018

VAERS ID: 291485 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 8/14/2018

VAERS ID: 291485 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 9/14/2018

VAERS ID: 291485 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.


Changed on 10/14/2018

VAERS ID: 291485 Before After
VAERS Form:1
Age:15.0
Sex:Female
Location:Colorado
Vaccinated:2007-05-14
Onset:2007-05-25
Submitted:2007-09-26
Entered:2007-09-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0011U / 3 GM / UN

Administered by: Other      Purchased by: Other
Symptoms:

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: 7     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown PMH: recurrent sinusitis (allergic) & tonsillar lymphadenopathy, lymphadenitis, 11/2006. Recurrent ear infections. PE tubes x 2. Allergy: PCN.
Allergies:
Diagnostic Lab Data: Unknown LABS: CT revealed chronic extensive multifocala sinusitis. Repeat CT of neck & chest revealed diffuse lymphadenopathy including spleen. Sed rate 31 (H). RA 95 (H). Monospot (+). CMV (-). EBV (H). Needle aspiration of lymph nodes revealed reactive disease. Blood c/s neg.
CDC 'Split Type': WAES0709USA03419

Write-up: Information has been received from a nurse concerning a 16 year old female patient who was vaccinated with a first dose of Gardasil, and subsequently developed flu-like symptoms. The patient also developed flu-like symptoms after getting the second dose of Gardasil. After getting the third dose of Gardasil, the patient developed kidney failure and underwent respiratory arrest resulting in hospitalization. At the time of the report the patient had not recovered. Additional information has been requested. 10/8/07 Patient demographics provided by CDC. 10/19/07 Reviewed hospital medical records which reveal patient experienced neck swelling, difficulty swallowing, cough, bloody sputum, facial pressure/pain, fatigue. Admitted 5/25-5/31/2007. ID & ENT consults done. Tx w/IV antibiotics & developed red man syndrome, antibiotics changed. Improved & d/c to home on continued IV antibiotics via PICC line. To f/u w/ENT & ID, & have repeat CT scan done. Records do not have evidence of respiratory arrest or renal failure reported by manufacturer. FINAL DX: Sinusitis, lymphadenitis, parotitis & Epstein-Barr virus. 11/16/07 Reviewed vax records from provider. VAERS database updated w/same.

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