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This is VAERS ID 367604

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

VAERS ID: 367604
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-10-30
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / - AR / IJ

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Asthenia, Convulsion, Dizziness, Headache

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort


Changed on 1/5/2010

VAERS ID: 367604 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2007-10-30 2008-06-18
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - 0070X / - 3 AR / IJ

Administered by: Private Unknown      Purchased by: Private Unknown
Symptoms: Abdominal discomfort, Asthenia, Convulsion, Dizziness, Headache

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort 12/17/09 clinic records received for DOS 07/31/07and 6/18/08 and vaccination list record received for DOS 12/09/1993 thr 06/18/2008. DX: Well Adolescent Care, Acne 07/31/07 office note docu. sports physical with unlimited participation. 06/18/08 office note notes c/o not sleeping well and insect bite X 1wk. Parent concerned about excessive sleep and sweats alot. Acne on face and upper back. Prescriptions given:clindamycin phosphate 1% TOP, benzoyl peroxide 6% TOP and differin 0.1% TOP. Vaccination rec reflect patient received HPV on 07/31/07, 10/09/07 and 06/18/08.


Changed on 2/5/2010

VAERS ID: 367604 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2008-06-18
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 3 AR LA / IJ IM

Administered by: Unknown Private      Purchased by: Unknown Private
Symptoms: Abdominal discomfort, Asthenia, Convulsion, Dizziness, Headache

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort 12/17/09 clinic records received for DOS 07/31/07and 6/18/08 and vaccination list record received for DOS 12/09/1993 thr 06/18/2008. DX: Well Adolescent Care, Acne 07/31/07 office note docu. sports physical with unlimited participation. 06/18/08 office note notes c/o not sleeping well and insect bite X 1wk. Parent concerned about excessive sleep and sweats alot. Acne on face and upper back. Prescriptions given:clindamycin phosphate 1% TOP, benzoyl peroxide 6% TOP and differin 0.1% TOP. Vaccination rec reflect patient received HPV on 07/31/07, 10/09/07 and 06/18/08.


Changed on 7/31/2010

VAERS ID: 367604 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2008-06-18
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Acne, Arthropod bite, Asthenia, Convulsion, Dizziness, Headache, Hyperhidrosis, Hypersomnia, Sleep disorder

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort 12/17/09 clinic records received for DOS 07/31/07and 6/18/08 and vaccination list record received for DOS 12/09/1993 thr 06/18/2008. DX: Well Adolescent Care, Acne 07/31/07 office note docu. sports physical with unlimited participation. 06/18/08 office note notes c/o not sleeping well and insect bite X 1wk. Parent concerned about excessive sleep and sweats alot. Acne on face and upper back. Prescriptions given:clindamycin phosphate 1% TOP, benzoyl peroxide 6% TOP and differin 0.1% TOP. Vaccination rec reflect patient received HPV on 07/31/07, 10/09/07 and 06/18/08.


Changed on 8/31/2010

VAERS ID: 367604 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2008-06-18
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Acne, Arthropod bite, Asthenia, Convulsion, Dizziness, Headache, Hyperhidrosis, Hypersomnia, Sleep disorder, Stomach discomfort

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort 12/17/09 clinic records received for DOS 07/31/07and 6/18/08 and vaccination list record received for DOS 12/09/1993 thr 06/18/2008. DX: Well Adolescent Care, Acne 07/31/07 office note docu. sports physical with unlimited participation. 06/18/08 office note notes c/o not sleeping well and insect bite X 1wk. Parent concerned about excessive sleep and sweats alot. Acne on face and upper back. Prescriptions given:clindamycin phosphate 1% TOP, benzoyl peroxide 6% TOP and differin 0.1% TOP. Vaccination rec reflect patient received HPV on 07/31/07, 10/09/07 and 06/18/08.


Changed on 1/4/2011

VAERS ID: 367604 Before After
Age:14.0
Gender:Female
Location:California
Vaccinated:2008-06-18
Onset:2009-02-20
Submitted:2009-11-16
Entered:2009-11-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0070X / 3 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Abdominal discomfort, Acne, Arthropod bite, Asthenia, Convulsion, Dizziness, Headache, Hyperhidrosis, Hypersomnia, Sleep disorder, Stomach discomfort

Life Threatening? No
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:seizure, headache,dizziness, weakness, stomach discomfort 12/17/09 clinic records received for DOS 07/31/07and 6/18/08 and vaccination list record received for DOS 12/09/1993 thr 06/18/2008. DX: Well Adolescent Care, Acne 07/31/07 office note docu. sports physical with unlimited participation. 06/18/08 office note notes c/o not sleeping well and insect bite X 1wk. Parent concerned about excessive sleep and sweats alot. Acne on face and upper back. Prescriptions given:clindamycin phosphate 1% TOP, benzoyl peroxide 6% TOP and differin 0.1% TOP. Vaccination rec reflect patient received HPV on 07/31/07, 10/09/07 and 06/18/08.


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