National Vaccine
Information Center

Your Health. Your Family. Your Choice.

MedAlerts Home
Search Results

This is VAERS ID 367604

History of Changes from the VAERS Wayback Machine

First Appeared on 12/8/2009

367604
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

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


Changed on 1/5/2010

367604 Before After
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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

367604 Before After
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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

367604 Before After
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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

367604 Before After
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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

367604 Before After
VAERS Form:
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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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 9/14/2017

367604 Before After
VAERS Form:(blank) 1
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 4 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
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:
Current Illness: felt weak,nausea,dizzy,passing out
Preexisting Conditions: none
Allergies:
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.


New Search

Link To This Search Result:

http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=367604&WAYBACKHISTORY=ON


Copyright © 2017 National Vaccine Information Center. All rights reserved.
21525 Ridgetop Circle, Suite 100, Sterling, VA 20166