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This is VAERS ID 311786

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

311786
VAERS Form:
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2007-04-06
Onset:2008-04-25
Submitted:2008-05-06
Entered:2008-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0088U / 0 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose abnormal, Vision blurred, Weight decreased, Type 1 diabetes mellitus

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: serum glucose, 25Apr08, 386 mg/dL
CDC 'Split Type': WAES0804USA06287

Write-up:Information has been received from a physician and a medical assistant concerning a 12 year old female patient who on 06-APR-2007 was vaccinated IM with a first dose of Gardasil ( lot #655324/0088U) and on 02-AUG-2007 she was was vaccinated with a second dose of Gardasil ( lot # 657622/0388U). On 16-JAN-2008 she was was vaccinated her third dose of Gardasil ( lot # 657868/0523U). No concomitant therapy was reported. The physician reported that the patient developed diabetes Type 1 after receiving three doses of Gardasil. She was examined in the hospital on 25-APR-2008 and on 28-APR-2008. She was not admitted to the hospital on either occasion. The patient was started on insulin. No further information was provided. The patient''s outcome was not recovered. In follow up telephone call the medical assistant reported that the patient began experiencing rapid weight loss and blurry vision (dates not reported). She was diagnosed with Type 1 diabetes. The physician considered patient starting on insulin to be life threatening and disabling and an important medical event. Additional information has been requested.


Changed on 9/14/2017

311786 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Foreign
Vaccinated:2007-04-06
Onset:2008-04-25
Submitted:2008-05-06
Entered:2008-05-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0088U / 0 1 UN / UN

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose abnormal, Vision blurred, Weight decreased, Type 1 diabetes mellitus

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: Unknown
Current Illness:
Preexisting Conditions: Unknown
Allergies:
Diagnostic Lab Data: serum glucose, 25Apr08, 386 mg/dL
CDC 'Split Type': WAES0804USA06287

Write-up:Information has been received from a physician and a medical assistant concerning a 12 year old female patient who on 06-APR-2007 was vaccinated IM with a first dose of Gardasil ( lot #655324/0088U) and on 02-AUG-2007 she was was vaccinated with a second dose of Gardasil ( lot # 657622/0388U). On 16-JAN-2008 she was was vaccinated her third dose of Gardasil ( lot # 657868/0523U). No concomitant therapy was reported. The physician reported that the patient developed diabetes Type 1 after receiving three doses of Gardasil. She was examined in the hospital on 25-APR-2008 and on 28-APR-2008. She was not admitted to the hospital on either occasion. The patient was started on insulin. No further information was provided. The patient''s outcome was not recovered. In follow up telephone call the medical assistant reported that the patient began experiencing rapid weight loss and blurry vision (dates not reported). She was diagnosed with Type 1 diabetes. The physician considered patient starting on insulin to be life threatening and disabling and an important medical event. Additional information has been requested.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=311786&WAYBACKHISTORY=ON


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