National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 340807

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

340807
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance,


Changed on 3/2/2010

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance,


Changed on 4/7/2010

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance,


Changed on 1/4/2011

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 4/13/2011

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 5/13/2011

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 6/11/2011

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 6/14/2014

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 4/14/2017

340807 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Apathy, Back pain, Blood thyroid stimulating hormone, Cardiac enzymes normal, Chest X-ray normal, Chronic fatigue syndrome, Computerised tomogram normal, Cough, Culture stool, Culture urine, Depression, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Epstein-Barr virus infection, Fatigue, Full blood count normal, Gait disturbance, Headache, Hypoaesthesia, Insomnia, Irritability, Lip swelling, Mood swings, Nausea, Neck pain, Pain in extremity, Paraesthesia, Presyncope, Rhinorrhoea, Sensation of heaviness, Staring, Vomiting, Red blood cell sedimentation rate normal, Dysstasia, Free thyroxine index, Activities of daily living impaired, Epstein-Barr virus antibody positive, Neurological examination normal, DNA antibody negative, Decreased appetite, Metabolic function test normal, Non-cardiac chest pain, Increased upper airway secretion, Streptococcus identification test positive, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


Changed on 9/14/2017

340807 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Colorado
Vaccinated:2008-11-11
Onset:2008-11-12
Submitted:2009-02-26
Entered:2009-02-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0570X / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Abdominal pain, Alopecia, Amnesia, Antinuclear antibody, Back pain, Blood thyroid stimulating hormone, Culture stool, Culture urine, Diarrhoea, Disturbance in attention, Dyspnoea, Electrocardiogram, Fatigue, Headache, Hypoaesthesia, Lip swelling, Nausea, Neck pain, Pain in extremity, Paraesthesia, Staring, Vomiting, Dysstasia, Free thyroxine index, Activities of daily living impaired, Streptococcus identification test

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: none
Current Illness: none
Preexisting Conditions: none PMH: acute pharyngitis, HA, acute sinusitis, cough, acne vulgaris tx w/minocin, abdominal pain, diarrhea. Family hx: depression, suicide.
Allergies:
Diagnostic Lab Data: ESR, ASO, FT4, TSH, ANA TITER, ANTI-DS-DNA, EBV AB PROFILE ACT WKST: FANA, STOOL, URINE, CARDIAC ENZYMES, EKG, CHEST X-RAY, CAT SCAN - NEURO TESTING IS NEXT WEEK. LABS 2/18/09: ASO 161(H). EBV IgG (+), nuclear antigen neg, IgM (+). ESR 3. TSH 1.60, anti-DNA neg. BMP, CBC, Troponin I, CPK, CK-MB, CXR & CT chest WNL.
CDC 'Split Type':

Write-up:chronic debilitating headaches, chronic diahrrea, severe back & abdominal pain, tingling in hands and feet,numbness in hands & feet, stabbing pain in lower legs and feet, inability to stand, inability to walk, difficulty breathing, swollen lips, chest pain in conjunction with neck pain, loss of hair, chronic debilitating fatigue, nausea, vomiting, short term memory loss, inability to concentrate, stares off in the distance for long periods of time. These started right after the vaccination and continue to this day & have made her life as she knew it unmanageable. She can no longer attend school. Numerous trips to her pediatrician, blood tests, urine test, stool tests, emergency room visits, referred to neurologists, nutritionist. No one knows how to treat her. There is no treatment apparently. 3/16/09 Received consult records of 2/24/2009. FINAL DX: probable chronic fatigue syndrome, possibly exacerbated by recent EBV infection; reactive depression; likely vasovagal episodes; possible anxiety disorder. Records reveal patient experienced fatigue, nausea, numbness/tingling of hands/feet, HA, neck pain, intermittent diarrhea, chest pain w/SOB & heart pounding, intermittent difficulty walking, difficulty concentrating, decreased appetite, insomnia, apathy, moody, irritable. Approx 1 wk after initial HPV & Depoprovera injections, 11/12/08, developed waxing/waning fatigue which escalated to missing school in Dec & Jan. Suggested antidepressant & counseling. 3/9/09 Received PCP medical records of 2/2007-3/2/2009 included ER records of 2/9/2009. FINAL DX:none provided Records reveal patient experienced good health on 11/12, received depo-provera 1st dose along w/HPV #1. RTC 2/11 s/p ER visit 2/9 for chest pain, cough, runny nose, phlegm congestion. Parent reported back pain, hand tremors, leg pain, leg swelling, back pain, dizziness, joint stiffness, decreased concentration, fatigue, intermittent diarrhea, nausea since 11/08. Missed several days of school. Developed leg heaviness, gait disturbance, & LE weakness & increased fatigue. Referred to ID & Neuro but no records available. ER records 2/9/09 FINAL DX: atypical chest pain Records reveal patient experienced sharp nonradiating chest pain, rapid breathing & tingling of hands/feet all of which had resolved by the time she was seen in ER.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=340807&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166