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This is VAERS ID 391817

Case Details

VAERS ID: 391817 (history)  
Form: Version 1.0  
Age: 14.0  
Gender: Female  
Location: Oklahoma  
Vaccinated:2007-02-05
Onset:2007-03-26
   Days after vaccination:49
Submitted: 2010-06-30
   Days after onset:1192
Entered: 2010-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1208F / 1 AR / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1875AA / 1 AR / UN

Administered by: Public       Purchased by: Private
Symptoms: Dehydration, Fatigue, Hypothyroidism, Type 1 diabetes mellitus, Weight decreased
SMQs:, Hyperglycaemia/new onset diabetes mellitus (narrow), Hypothyroidism (narrow)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 5 days
   Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: no
Preexisting Conditions: seasonal allergies
Allergies:
Diagnostic Lab Data: Doctor ran all tests and blood work.
CDC Split Type:

Write-up: Over a 3 week period patient lost 20 pounds, extremely tired, & dehydrated. On 3-26-07 she was diagnosed with Type 1 Diabetes and Hypothyroid. She was admitted with a 1075 blood sugar. No family history of Diabetes.


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