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This is VAERS ID 453908

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/12/2012

VAERS ID: 453908
VAERS Form:
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 0 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 9/14/2017

VAERS ID: 453908 Before After
VAERS Form:(blank) 1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 0 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 2/14/2018

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 6/14/2018

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 8/14/2018

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 9/14/2018

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 10/14/2018

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 12/24/2020

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 12/30/2020

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 5/7/2021

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.


Changed on 5/14/2021

VAERS ID: 453908 Before After
VAERS Form:1
Age:14.0
Sex:Male
Location:Washington
Vaccinated:2011-08-30
Onset:2012-04-12
Submitted:2012-04-16
Entered:2012-04-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV2: HPV (CERVARIX) / GLAXOSMITHKLINE BIOLOGICALS AHPVA113AA / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U3846AA / 1 LA / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthma, Blood glucose increased, Cachexia, Condition aggravated, Cough, Dehydration, Diarrhoea, Glucose urine present, Polydipsia, Polyuria, Weight decreased, Wrong drug administered, Urine ketone body present, Type 1 diabetes mellitus

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

Write-up: Per mother since vaccination, pt started to lose weight & was diagnosed with Type I DM 4/12/12, concerned because pt was given CERVARIX in error.

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https://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=453908&WAYBACKHISTORY=ON


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