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This is VAERS ID 337797

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History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 337797
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Nasal congestion, Autopsy, Cell death, Abnormal behaviour, Clostridium difficile toxin test positive, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0~Patient|none~ ()~~0~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 8/13/2012

VAERS ID: 337797 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiomegaly, Cervicitis, Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Mitral valve incompetence, Muscle spasms, Nasal congestion, Respiratory papilloma, Ventricular hypertrophy, Autopsy, Cell death, Abnormal behaviour, Cystitis noninfective, Clostridium difficile toxin test positive, Ventricular remodeling, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0~Patient|none~ ()~~0~Sibling ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 6/14/2014

VAERS ID: 337797 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiomegaly, Cervicitis, Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Mitral valve incompetence, Muscle spasms, Nasal congestion, Respiratory papilloma, Ventricular hypertrophy, Autopsy, Cell death, Abnormal behaviour, Cystitis noninfective, Clostridium difficile toxin test positive, Ventricular remodeling, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 2/14/2017

VAERS ID: 337797 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiomegaly, Cervicitis, Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Mitral valve incompetence, Muscle spasms, Nasal congestion, Respiratory papilloma, Ventricular hypertrophy, Autopsy, Cell death, Abnormal behaviour, Cystitis noninfective, Clostridium difficile toxin test positive, Ventricular remodeling, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications:
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 4/14/2017

VAERS ID: 337797 Before After
VAERS Form:
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Cardiomegaly, Cervicitis, Death, Dermatitis contact, Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Mitral valve incompetence, Muscle spasms, Nasal congestion, Respiratory papilloma, Ventricular hypertrophy, Autopsy, Cell death, Abnormal behaviour, Cystitis noninfective, Clostridium difficile toxin test positive, Ventricular remodeling, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 9/14/2017

VAERS ID: 337797 Before After
VAERS Form:(blank) 1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 2/14/2018

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 6/14/2018

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 8/14/2018

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 9/14/2018

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 10/14/2018

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 12/24/2020

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 12/30/2020

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 5/7/2021

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.


Changed on 5/21/2021

VAERS ID: 337797 Before After
VAERS Form:1
Age:18.0
Sex:Female
Location:New Mexico
Vaccinated:2007-01-03
Onset:2007-08-31
Submitted:2009-01-21
Entered:2009-01-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Fatigue, Headache, Hypersomnia, Menorrhagia, Menstrual disorder, Metrorrhagia, Muscle spasms, Abnormal behaviour

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2007-08-31
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: none~ ()~~0.00~Patient|none~ ()~~0.00~Sibling
Other Medications: Nasonex (Pseudovent 400 substituted for Entex 400 120 capsule),Claritan, Triamcinolene Acetonide cream for rash on wrist.
Current Illness: Went in for sinisitus, and had a sore throat. She had bad sinus allergies. But they still gave her the shots.
Preexisting Conditions: Seasonal allergies. None other.
Allergies:
Diagnostic Lab Data: 4/7/09-path report received-multiple tissues with extensive autolysis and bacterial overgrowth. Molecular evidence of a Clostridium sp.
CDC 'Split Type':

Write-up: Headaches, periods were very erratic. She would have them every 14 days @times, and others just spotting. Very bad cramps and periods were heavier after the 1st Gardasil shot. Wasn''t her normal spunky and happy self. She was very tired and the last few weeks before she passed away, sheslept alot during the day which she never did. Never had any other problems prior to the Gardasil shots. She recieved all three shots in the series. Last shot was 5-2-2007. 2/9/09-autopsy report received-COD-undetermined by autospy and toxicology.3/18/09-records received-well visit C/O contact dermatitis, nasal congestion, itchy sore throat times 2-3days. HPV4 lot#1424 F received 1/3/07 in right deltoid. Lot #0384U received 5/2/07 left deltoid and 12/2/08 lot#0955F left deltoid.

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