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This is VAERS ID 358916

Case Details

VAERS ID: 358916 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: New York  
Vaccinated:2008-04-07
Onset:2009-06-03
   Days after vaccination:422
Submitted: 2009-09-30
   Days after onset:119
Entered: 2009-09-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HEPA: HEP A (HAVRIX) / GLAXOSMITHKLINE BIOLOGICALS AHAVB256BA / 2 RA / IJ
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 19878U / 2 LA / IJ

Administered by: Unknown       Purchased by: Unknown
Symptoms: Blood test, Pollakiuria
SMQs:

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: nothing
Current Illness: none - vaccination was given at regular 11 yr old well child care check up
Preexisting Conditions: allergic to sulfa medications PMH: Diabetes , scoliosis Allergies: Sulfa
Allergies:
Diagnostic Lab Data: blood tests
CDC Split Type:

Write-up: Diagnosed with Type 1 diabetes two months later. Frequent urination started 6 wks after vaccination and diagnosed with diabetes 8 wks after vaccination. 1/7/2010 PCP records for 2 wellness visits, 4/2008 and 5/2009, on second visit it states patient on an Insulin pump x 2 months, stable HgbA1C, Dx IDDM


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