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This is VAERS ID 484683

History of Changes from the VAERS Wayback Machine

First Appeared on 3/12/2013

484683
VAERS Form:
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2012-10-10
Onset:2012-11-19
Submitted:2013-02-15
Entered:2013-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0131AE / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Insulin resistant diabetes, Type 1 diabetes mellitus, Insulin resistance test

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Type 1 diabetes - insulin resistent
CDC 'Split Type':

Write-up:Patient was diagnosed with type 1 diabetes.


Changed on 9/17/2013

484683 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2012-10-10
Onset:2012-11-19
Submitted:2013-02-15
Entered:2013-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0131AE / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Blood chloride decreased, Blood glucose increased, Blood sodium decreased, Ear pain, Glucose urine present, Glycosylated haemoglobin increased, Insulin resistant diabetes, Nocturia, Pollakiuria, Polydipsia, Rhinorrhoea, Sinus congestion, Thirst, Weight decreased, Type 1 diabetes mellitus, Insulin resistance test

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None The following information was obtained through follow-up and/or provided by the government. 02/19/13 PMH: Shaken baby syndrome, traumatic brain injury, learning disabilities, developmental delay, Lyme disease, heart murmur.
Allergies:
Diagnostic Lab Data: Type 1 diabetes - insulin resistent The following information was obtained through follow-up and/or provided by the government. 02/19/13 Labs and Diagnostics: CHEM - Glucose 524 mg/dl (H) Sodium 129 mmol/l (L) Chloride 94 mmol/l (L). Hemoglobin A1c 9.9% (H). Urinalysis - Glucose 500 (H).
CDC 'Split Type':

Write-up:Patient was diagnosed with type 1 diabetes. The following information was obtained through follow-up and/or provided by the government. 02/19/13 PCP medical and consultant records received. Service dates 07/31/12 to 11/20/12. Diagnosis: New Onset Type 1 Diabetes. Parent called, child has sinus congestion, green mucous, ear pain, Z-Pack prescribed. Subsequetly drinking excessively, very thirsty, frequent urination, waking up to urinate during the night. Weight loss. Insulin initiated.


Changed on 7/14/2014

484683 Before After
VAERS Form:
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2012-10-10
Onset:2012-11-19
Submitted:2013-02-15
Entered:2013-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0131AE / 1 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Blood chloride decreased, Blood glucose increased, Blood sodium decreased, Ear pain, Glucose urine present, Glycosylated haemoglobin increased, Insulin resistant diabetes, Nocturia, Pollakiuria, Polydipsia, Rhinorrhoea, Sinus congestion, Thirst, Weight decreased, Type 1 diabetes mellitus, Insulin resistance test

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None The following information was obtained through follow-up and/or provided by the government. 02/19/13 PMH: Shaken baby syndrome, traumatic brain injury, learning disabilities, developmental delay, Lyme disease, heart murmur.
Allergies:
Diagnostic Lab Data: Type 1 diabetes - insulin resistent The following information was obtained through follow-up and/or provided by the government. 02/19/13 Labs and Diagnostics: CHEM - Glucose 524 mg/dl (H) Sodium 129 mmol/l (L) Chloride 94 mmol/l (L). Hemoglobin A1c 9.9% (H). Urinalysis - Glucose 500 (H).
CDC 'Split Type':

Write-up:Patient was diagnosed with type 1 diabetes. The following information was obtained through follow-up and/or provided by the government. 02/19/13 PCP medical and consultant records received. Service dates 07/31/12 to 11/20/12. Diagnosis: New Onset Type 1 Diabetes. Parent called, child has sinus congestion, green mucous, ear pain, Z-Pack prescribed. Subsequetly drinking excessively, very thirsty, frequent urination, waking up to urinate during the night. Weight loss. Insulin initiated.


Changed on 9/14/2017

484683 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Connecticut
Vaccinated:2012-10-10
Onset:2012-11-19
Submitted:2013-02-15
Entered:2013-02-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0131AE / 1 2 UN / UN

Administered by: Private      Purchased by: Other
Symptoms: Insulin resistant diabetes, Type 1 diabetes mellitus, Insulin resistance test

Life Threatening? No
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? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Type 1 diabetes - insulin resistent
CDC 'Split Type':

Write-up:Patient was diagnosed with type 1 diabetes.


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