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This is VAERS ID 405873

History of Changes from the VAERS Wayback Machine

First Appeared on 11/3/2010

405873
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-06-22
Onset:2008-07-23
Submitted:2010-10-28
Entered:2010-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0319U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2296AA / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic, Type 1 diabetes mellitus

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Liberty Hospital and Childrens Mercy Hospital diagnosed with Diabetes Type 1.
CDC 'Split Type':

Write-up:Had strange itchy rash months before diagnosis, doctors recommended taking Claritan, did not diagnose. Also had DM Type 1 symptoms months before diagnosis.


Changed on 4/13/2011

405873 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-06-22
Onset:2008-07-23
Submitted:2010-10-28
Entered:2010-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0319U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2296AA / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Asthenia, Blood glucose increased, Bradycardia, Computerised tomogram abnormal, Constipation, Cough, Diabetes mellitus, Diarrhoea, Electrocardiogram abnormal, Fatigue, Glycosylated haemoglobin increased, Headache, Hyperglycaemia, Hypoglycaemia, Infectious mononucleosis, Lymphadenopathy, Mononucleosis heterophile test positive, Nausea, Pollakiuria, Rash, Rash pruritic, Rhinorrhoea, Supraventricular extrasystoles, Syncope, Tenderness, Upper respiratory tract infection, Viral infection, Vomiting, White blood cells urine positive, Excoriation, Urinary sediment present, Spleen palpable, Bacterial test positive, Blood alkaline phosphatase increased, Decreased appetite, X-ray limb normal, Urine analysis abnormal, Urine colour abnormal, Type 1 diabetes mellitus, Oropharyngeal pain, Streptococcus test, Streptococcus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Liberty Hospital and Childrens Mercy Hospital diagnosed with Diabetes Type 1.
CDC 'Split Type':

Write-up:Had strange itchy rash months before diagnosis, doctors recommended taking Claritan, did not diagnose. Also had DM Type 1 symptoms months before diagnosis.


Changed on 5/13/2011

405873 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-06-22
Onset:2008-07-23
Submitted:2010-10-28
Entered:2010-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0319U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2296AA / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal distension, Abdominal pain, Abdominal tenderness, Asthenia, Blood glucose increased, Bradycardia, Computerised tomogram abnormal, Constipation, Cough, Diabetes mellitus, Diarrhoea, Electrocardiogram abnormal, Fatigue, Glycosylated haemoglobin increased, Headache, Hyperglycaemia, Hypoglycaemia, Infectious mononucleosis, Lymphadenopathy, Mononucleosis heterophile test positive, Nausea, Pollakiuria, Rash, Rash pruritic, Rhinorrhoea, Supraventricular extrasystoles, Syncope, Tenderness, Upper respiratory tract infection, Viral infection, Vomiting, White blood cells urine positive, Excoriation, Urinary sediment present, Spleen palpable, Bacterial test positive, Blood alkaline phosphatase increased, Decreased appetite, X-ray limb normal, Urine analysis abnormal, Urine colour abnormal, Type 1 diabetes mellitus, Oropharyngeal pain, Streptococcus test, Streptococcus test negative

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Liberty Hospital and Childrens Mercy Hospital diagnosed with Diabetes Type 1.
CDC 'Split Type':

Write-up:Had strange itchy rash months before diagnosis, doctors recommended taking Claritan, did not diagnose. Also had DM Type 1 symptoms months before diagnosis.


Changed on 2/13/2013

405873 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-06-22
Onset:2008-07-23
Submitted:2010-10-28
Entered:2010-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0319U / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2296AA / 0 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic, Type 1 diabetes mellitus

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Liberty Hospital and Childrens Mercy Hospital 2 Hospitals diagnosed with Diabetes Type 1.
CDC 'Split Type':

Write-up:Had strange itchy rash months before diagnosis, doctors recommended taking Claritan, did not diagnose. Also had DM Type 1 symptoms months before diagnosis.


Changed on 9/14/2017

405873 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Missouri
Vaccinated:2007-06-22
Onset:2008-07-23
Submitted:2010-10-28
Entered:2010-10-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0319U / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2296AA / 0 1 LA / -

Administered by: Private      Purchased by: Private
Symptoms: Rash pruritic, Type 1 diabetes mellitus

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: 2 Hospitals diagnosed with Diabetes Type 1.
CDC 'Split Type':

Write-up:Had strange itchy rash months before diagnosis, doctors recommended taking Claritan, did not diagnose. Also had DM Type 1 symptoms months before diagnosis.


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