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This is VAERS ID 323639

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2008

323639
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2008-04-17
Onset:2008-06-15
Submitted:2008-08-28
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNK / 1 RA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Alopecia, Full blood count, Thyroid function 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: hair loss~Vaccine not specified (no brand name)~2~14~In Patient
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: ENVIRONMENTAL ALLERGIES
Allergies:
Diagnostic Lab Data: lab tests cbc and thyroid still pending. will have results within one week from today (August 28,2008)
CDC 'Split Type': ENVIRONMENTAL ALLERGIES

Write-up:2 out of 3 shots of GARDASIL administered. Alopecia was the diagnosis after seeing doctor August 27, 2008. Blotchy hair loss in the front of her head (pictures taken) 1st shot given in November, 2007 and second given in April, 2008. Hair loss began appro"x. June, 2008 and is progressively getting worse. Doctor prescribed Selenium Sulfide Lotion to use twice a week for 2 weeks. Does not believe there will be a change. Also went for blood work to check thyroid (August 28, 2008) Results not given as of yet


Changed on 12/8/2009

323639 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2008-04-17
Onset:2008-06-15
Submitted:2008-08-28
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNK / 1 RA / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Alopecia, Full blood count, Thyroid function 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: hair loss~Vaccine not specified (no brand name)~2~14~In Patient
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: ENVIRONMENTAL ALLERGIES
Allergies:
Diagnostic Lab Data: lab tests cbc and thyroid still pending. will have results within one week from today (August 28,2008)
CDC 'Split Type': ENVIRONMENTAL ALLERGIES (blank)

Write-up:2 out of 3 shots of GARDASIL administered. Alopecia was the diagnosis after seeing doctor August 27, 2008. Blotchy hair loss in the front of her head (pictures taken) 1st shot given in November, 2007 and second given in April, 2008. Hair loss began appro"x. approx. June, 2008 and is progressively getting worse. Doctor prescribed Selenium Sulfide Lotion to use twice a week for 2 weeks. Does not believe there will be a change. Also went for blood work to check thyroid (August 28, 2008) Results not given as of yet yet.


Changed on 4/14/2017

323639 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:New York
Vaccinated:2008-04-17
Onset:2008-06-15
Submitted:2008-08-28
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNK / 1 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alopecia, Full blood count, Thyroid function 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: hair loss~Vaccine not specified (no brand name)~2~14~In name)~2~14.30~In Patient
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: ENVIRONMENTAL ALLERGIES
Allergies:
Diagnostic Lab Data: lab tests cbc and thyroid still pending. will have results within one week from today (August 28,2008)
CDC 'Split Type':

Write-up:2 out of 3 shots of GARDASIL administered. Alopecia was the diagnosis after seeing doctor August 27, 2008. Blotchy hair loss in the front of her head (pictures taken) 1st shot given in November, 2007 and second given in April, 2008. Hair loss began approx. June, 2008 and is progressively getting worse. Doctor prescribed Selenium Sulfide Lotion to use twice a week for 2 weeks. Does not believe there will be a change. Also went for blood work to check thyroid (August 28, 2008) Results not given as of yet.


Changed on 9/14/2017

323639 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:New York
Vaccinated:2008-04-17
Onset:2008-06-15
Submitted:2008-08-28
Entered:2008-08-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
UNK: VACCINE NOT SPECIFIED (NO BRAND NAME) / UNKNOWN MANUFACTURER UNK / 1 2 RA / IM

Administered by: Private      Purchased by: Private
Symptoms: Alopecia, Full blood count, Thyroid function 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations: hair loss~Vaccine not specified (no brand name)~2~14.30~In Patient
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: ENVIRONMENTAL ALLERGIES
Allergies:
Diagnostic Lab Data: lab tests cbc and thyroid still pending. will have results within one week from today (August 28,2008)
CDC 'Split Type':

Write-up:2 out of 3 shots of GARDASIL administered. Alopecia was the diagnosis after seeing doctor August 27, 2008. Blotchy hair loss in the front of her head (pictures taken) 1st shot given in November, 2007 and second given in April, 2008. Hair loss began approx. June, 2008 and is progressively getting worse. Doctor prescribed Selenium Sulfide Lotion to use twice a week for 2 weeks. Does not believe there will be a change. Also went for blood work to check thyroid (August 28, 2008) Results not given as of yet.


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