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This is VAERS ID 348870

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 348870
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Protein urine present, Urine analysis abnormal

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 7/31/2010

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial test

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time p
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 8/31/2010

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, pH urine increased, Rash, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Bacteria urine, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time p
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 1/4/2011

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, pH urine increased, Rash, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Bacteria urine, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time p patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 4/13/2011

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 5/13/2011

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 6/11/2011

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 6/14/2014

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 4/14/2017

VAERS ID: 348870 Before After
VAERS Form:
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Blood potassium decreased, Dizziness, Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Mean cell haemoglobin increased, pH urine increased, Rash, Rash pruritic, Syncope, Urine abnormality, Urticaria, Visual impairment, Urine phosphate decreased, Protein urine present, Blood test abnormal, Urine analysis abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 9/14/2017

VAERS ID: 348870 Before After
VAERS Form:(blank) 1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 2 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 2/14/2018

VAERS ID: 348870 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 6/14/2018

VAERS ID: 348870 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 8/14/2018

VAERS ID: 348870 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 9/14/2018

VAERS ID: 348870 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.


Changed on 10/14/2018

VAERS ID: 348870 Before After
VAERS Form:1
Age:17.0
Sex:Female
Location:Texas
Vaccinated:2009-04-21
Onset:2009-04-23
Submitted:2009-06-10
Entered:2009-06-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1130X / 3 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Fall, Full blood count, Hypokalaemia, Mean cell haemoglobin, Rash, Syncope, Urticaria, Visual impairment, Urine phosphate decreased, Blood test abnormal, Bacterial 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)? Yes
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness:
Preexisting Conditions: 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Chicken pox. Bulemia, depression.
Allergies:
Diagnostic Lab Data: Immunocap. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. LABS and DIAGNOSTICS: CHEM - Postassium 2.7 mmol/L (L). CBC - MCH 31.5 PG (H). Urinalysis - pH 9.0 (H), Protein trace, Bacteria 3+, Mucous trace, Amorph Phos 2+. Last time patient seen in office was 1 yr ago (6/2009) numbers that we have for contact are no longer current. Can''t get ahold of patient to know if patient has recovered.
CDC 'Split Type':

Write-up: Rash beginning on bilateral arms. On and off x 1 wk. Rash down bilateral legs and cont. on arms x 3-4 days. Began with rash to face and neck 6-8-09 comes and goes. Rash seized yesterday began again today. 7/24/09 ER records received DOS 6/3/09 and 6/22/09. Assessment: Hives/Urticaria. Hypokalemia, bulemia. Patient presents on 6/3/09 with an itchy urticarial rash on arms, legs and trunk, of one month duration. On 6/22/09 c/o syncope X2, feels weak, falling. Lightheadedness, trouble with vision. Collapsed.

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