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This is VAERS ID 356938

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 356938
VAERS Form:
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Biopsy heart abnormal, Bronchitis, Chest pain, Chills, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea, Pain, Petechiae, Productive cough, Pulmonary congestion, Pulmonary oedema, Pyrexia, Sputum discoloured, Sternal fracture, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 4/14/2017

VAERS ID: 356938 Before After
VAERS Form:
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 2 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Arrhythmia, Biopsy heart abnormal, Bronchitis, Chest pain, Chills, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea, Pain, Petechiae, Productive cough, Pulmonary congestion, Pulmonary oedema, Pyrexia, Sputum discoloured, Sternal fracture, Oropharyngeal pain

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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 ()~~0.00~Patient
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 9/14/2017

VAERS ID: 356938 Before After
VAERS Form:(blank) 1
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 2 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 2/14/2018

VAERS ID: 356938 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 6/14/2018

VAERS ID: 356938 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 8/14/2018

VAERS ID: 356938 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.


Changed on 9/14/2018

VAERS ID: 356938 Before After
VAERS Form:1
Age:19.0
Gender:Female
Location:Oklahoma
Vaccinated:2008-07-21
Onset:2008-09-12
Submitted:2009-09-10
Entered:2009-09-10
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 17400 / 3 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Chest pain, Death, Dizziness, Dyspnoea, Fatigue, Feeling cold, Headache, Muscle spasms, Nausea

Life Threatening? No
Birth Defect? No
Died? Yes
   Date died:2008-09-12
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
Other Medications: Yaz until 3/17/08. Femcon beginning 3/17/08. Anaprox as needed.
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: None. I do have copies of all medical history from 01/08/2004 to the time of her death that I can provide if needed. The Medical Examiners office will have tissue samples until 4/2010.
CDC 'Split Type':

Write-up: Headache, Nausea, dizziness, chilling, tiredness, shortness of breath, complained of chest plain, severe cramps. 9/14/09 Received vaccine & PCP medical records which reveal patient seen 12/5/07 & 2/27/08 with sore throat, fever, chills, fatigue, body aches, productive cough w/yellow sputum & HA. Dx both times w/acute bronchitis & tx w/antibiotics & cough syrup. 9/25/09 Autopsy report received DOD 09/12/2008. Acute Cardiac Arrhythmia of Unknown Etiology. Addtional information abstracted: Heart with focal microscopic ischemic changes, pulmonary congestion and edema. Rare petechiae: conjunctival, periorbital and laryngeal. Resuscitation related sternal fracture.

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