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This is VAERS ID 375681

History of Changes from the VAERS Wayback Machine

First Appeared on 1/5/2010

VAERS ID: 375681
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Arthralgia, Chest pain, Chills, Confusional state, Convulsion, Cough, Depression, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Feeling hot, Gastrooesophageal reflux disease, Headache, Heat exhaustion, Hyperhidrosis, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Memory impairment, Myalgia, Night sweats, Odynophagia, Palpitations, Somnolence, Tinnitus, Urticaria, Weight increased, Fibromyalgia, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (Influenza (H1N1) (UNKNOWN MANUFACTURER))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 7/31/2010

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Arthralgia, Chest pain, Chills, Confusional state, Convulsion, Cough, Depression, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Feeling hot, Gastrooesophageal reflux disease, Headache, Heat exhaustion, Hyperhidrosis, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Memory impairment, Myalgia, Night sweats, Odynophagia, Palpitations, Somnolence, Tinnitus, Urticaria, Weight increased, Fibromyalgia, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (Influenza (H1N1) (UNKNOWN MANUFACTURER))~~10.00~Sibling (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 8/31/2010

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Adenotonsillectomy, Arthralgia, Chest pain, Chills, Confusional state, Convulsion, Cough, Depression, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Feeling hot, Gastrooesophageal reflux disease, Headache, Heat exhaustion, Hyperhidrosis, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Memory impairment, Myalgia, Night sweats, Odynophagia, Palpitations, Pharyngolaryngeal pain, Somnolence, Tinnitus, Urticaria, Weight increased, Fibromyalgia, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 12/7/2010

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Adenotonsillectomy, Arthralgia, Chest pain, Chills, Confusional state, Convulsion, Cough, Depression, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Feeling hot, Gastrooesophageal reflux disease, Headache, Heat exhaustion, Hyperhidrosis, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Memory impairment, Myalgia, Night sweats, Odynophagia, Palpitations, Pharyngolaryngeal pain, Somnolence, Tinnitus, Urticaria, Weight increased, Fibromyalgia, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 4/13/2011

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 5/13/2011

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 6/11/2011

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Susanne was treated at Centegra hospital in McHenry on the following dates:5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 1/7/2013

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Susanne Patient has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Susanne Patient was treated at Centegra hospital in McHenry on the following dates:5/7/07, dates: 5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardisil Gardasil vaccine. She was also treated at Mercy Healthcare of Crystal Lake, McHenry, Woodstock, and Harvard by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Susanne Patient was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lathargic, lethargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 6/14/2014

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Patient has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Patient was treated at hospital on the following dates: 5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardasil vaccine. She was also treated by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Patient was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lethargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


Changed on 3/14/2015

VAERS ID: 375681 Before After
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2007-04-17
Onset:2007-04-19
Submitted:2010-01-03
Entered:2010-01-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 AR / IM

Administered by: Public      Purchased by: Other
Symptoms: Abdominal pain, Activated partial thromboplastin time, Adenotonsillectomy, Anxiety, Arthralgia, Asthenia, Blood potassium decreased, Blood sodium decreased, Blood thyroid stimulating hormone normal, Candidiasis, Change of bowel habit, Chest pain, Chest X-ray normal, Chills, Colonoscopy, Condition aggravated, Confusional state, Convulsion, Cough, Depression, Diarrhoea, Dizziness, Dyspepsia, Dysphagia, Dysphonia, Dyspnoea, Ear pain, Electroencephalogram normal, Fatigue, Feeling hot, Full blood count, Gastritis, Gastrooesophageal reflux disease, Haemorrhoids, Headache, Heat exhaustion, Hyperhidrosis, Hypermobility syndrome, Hypersensitivity, Hypersomnia, Irritable bowel syndrome, Lethargy, Malaise, Memory impairment, Mononucleosis heterophile test negative, Muscle spasms, Myalgia, Nasal congestion, Nausea, Neck pain, Night sweats, Nuclear magnetic resonance imaging brain normal, Odynophagia, Oesophagitis, Pain, Palpitations, Paraesthesia, Pharyngitis, Prothrombin time normal, Pyrexia, Rash, Sleep disorder, Somnolence, Staring, Thyroxine, Tinnitus, Urticaria, Vomiting, Weight increased, White blood cell count increased, Fibromyalgia, Myofascial pain syndrome, Activities of daily living impaired, Oesophagogastroduodenoscopy, Urine human chorionic gonadotropin negative, Influenza serology negative, Metabolic function test, Hypophagia, Streptococcus identification test negative, Oropharyngeal pain

Life Threatening? Yes
Died? No
Permanent Disability? Yes
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations: Seizures~Influenza (H1N1) (H1N1 (MONOVALENT) (UNKNOWN))~~10.00~Sibling
Other Medications: Clonidine 0.1mg one in AM 1/2 in PM, Levoxyl once daily, Albuterol PRN.
Current Illness: No
Preexisting Conditions: Hypothyroid, Depression, Allergy to Adderal, Rapid Eye Blinking PMH: Depression, Bipolar, Asthma, Hypothyroidism, Hx of tics (blinking frequently) Allergies: Adderal, Lamictal
Diagnostic Lab Data: Patient has recieved treatment from multiple physicians and specialists and at several facilities (listed above). Medical records can be requested from each location. Dx studies: Ct abdomen and pelvis done 6/2009 wnl, Colonoscopy noted a spastic colon with internal hemorrhoids, EGD noted esophagitis, gastritis
CDC 'Split Type':

Write-up:Patient was treated at hospital on the following dates: 5/7/07, 5/9/07, 10/26/07, 12/09/07, 02/05/08, 03/12/08, 04/16/08, 04/17/08, 05/08/08, 10/19/08, 11/18/08/04/01/09, 05/18/09, 05/27/09, 05/28/09 through 5/31/09, 09/03/09 9/17/09, 09/20/09, 09/23/09, 10/19/09, 10/23/09, 10/26/09 through 10/28/09, 11/17/09, 11/23/09, 11/24/09, 12/14/09, and 12/25/09 for medical issues relating to adverse reaction to the Gardasil vaccine. She was also treated by multiple physicians on the following dates: 04/17/07, 05/16/07, 06/29/07, 10/08/08, 10/15/08, 11/13/08, 01/28/09, 02/11/09, 04/02/09, 05/12/09, 05/28/09, 06/02/09, 06/10/09, 07/02/09, 07/28/09, 08/12/09, 09/14/09, 09/21/09, 09/25/09 by two separate physicians, 10/09/09, 10/12/09, 10/19/09, 11/09/09, 11/16/09, 11/17/09, 11/23/09, 11/30/09, 12/02/09, 12/11/09, 12/14/09, and 01/01/10. Patient was seen and treated for the following ongoing medical issues: Fibromyalgia, environmental allergic reactions, hoarseness, coughing, shortness of breath, difficulty/pain when swallowing, continued throat pain, dizziness, repeated severe headaches, light headed, chills, overheated, excessive night sweating, lethargic, sleeping for entire day without waking rested, confusion/short term memory issues, seizures, sharp chest pains, racing heart, muscle/joint aches, hives on trunk/arms/shoulders, ringing in ears, severe depression, twisted/spastic colon, acid reflux, heartburn, weight gain. 1/4/2010 GI consult records for 9/14/2009, patient with chronic but progressively worse abdominal pain of ? etiology, increased fatigue, non-specific chest pain, change in bowel movements, alternating constipation and diarrhea, cold sweats and SOB with exertion, weakness with sensation of knees giving away


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