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This is VAERS ID 350021

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

350021
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-08-06
Onset:2007-12-01
Submitted:2009-06-24
Entered:2009-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 2 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Audiogram abnormal, Dizziness, Fatigue, Headache, Menorrhagia, Menstruation irregular, Mood swings, Palpitations, Pollakiuria, Hearing aid user, Deafness bilateral, Spinal deformity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL XR
Current Illness: acne; finger injury
Preexisting Conditions: 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. ADD. Ingrown toenail. Acute bronchitis. Allergic rhinitis.
Allergies:
Diagnostic Lab Data: failed school hearing test
CDC 'Split Type':

Write-up:Mom stated Pt developed hearing loss to both ears Dec 07 shortly after completing GARDASIL series. Dose #1 1/23/07 - Dose#2 3/29/07 - Dose#3 8/6/07 - Pt now wears hearing aids. 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. Assessment: Hearing impaired in both ears. Patient''s parent reports that child has failed school hearing test, now wears hearing aids. Acne, headaches, fatigue. Palpitations. Urinating more frequently. Dizziness. Mood swings. Menstrual cycles heavy and irregular. Thoracic spine, mild curvature to the left.


Changed on 4/14/2017

350021 Before After
VAERS Form:
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-08-06
Onset:2007-12-01
Submitted:2009-06-24
Entered:2009-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 2 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Acne, Audiogram abnormal, Dizziness, Fatigue, Headache, Menorrhagia, Menstruation irregular, Mood swings, Palpitations, Pollakiuria, Hearing aid user, Deafness bilateral, Spinal deformity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL XR
Current Illness: acne; finger injury
Preexisting Conditions: 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. ADD. Ingrown toenail. Acute bronchitis. Allergic rhinitis.
Allergies:
Diagnostic Lab Data: failed school hearing test
CDC 'Split Type':

Write-up:Mom stated Pt developed hearing loss to both ears Dec 07 shortly after completing GARDASIL series. Dose #1 1/23/07 - Dose#2 3/29/07 - Dose#3 8/6/07 - Pt now wears hearing aids. 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. Assessment: Hearing impaired in both ears. Patient''s parent reports that child has failed school hearing test, now wears hearing aids. Acne, headaches, fatigue. Palpitations. Urinating more frequently. Dizziness. Mood swings. Menstrual cycles heavy and irregular. Thoracic spine, mild curvature to the left.


Changed on 9/14/2017

350021 Before After
VAERS Form:(blank) 1
Age:12.0
Gender:Female
Location:Texas
Vaccinated:2007-08-06
Onset:2007-12-01
Submitted:2009-06-24
Entered:2009-06-24
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0014U / 2 3 LL / IM

Administered by: Private      Purchased by: Private
Symptoms: Hearing aid user, Deafness bilateral

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: ADDERALL XR
Current Illness: acne; finger injury
Preexisting Conditions: 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. ADD. Ingrown toenail. Acute bronchitis. Allergic rhinitis.
Allergies:
Diagnostic Lab Data: failed school hearing test
CDC 'Split Type':

Write-up:Mom stated Pt developed hearing loss to both ears Dec 07 shortly after completing GARDASIL series. Dose #1 1/23/07 - Dose#2 3/29/07 - Dose#3 8/6/07 - Pt now wears hearing aids. 7/8/09 Medical records received DOS 8/6/07 to 6/24/09. Assessment: Hearing impaired in both ears. Patient''s parent reports that child has failed school hearing test, now wears hearing aids. Acne, headaches, fatigue. Palpitations. Urinating more frequently. Dizziness. Mood swings. Menstrual cycles heavy and irregular. Thoracic spine, mild curvature to the left.


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