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This is VAERS ID 486419

History of Changes from the VAERS Wayback Machine

First Appeared on 7/7/2013

486419
VAERS Form:
Age:11.0
Gender:Female
Location:Foreign
Vaccinated:2010-12-03
Onset:2010-12-05
Submitted:2013-03-07
Entered:2013-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ53440 / 2 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blood glucose increased, Blood immunoglobulin E increased, Blood immunoglobulin M increased, Diabetes mellitus, Polydipsia, Polyuria, Antibody test, Streptococcus test, Streptococcus test negative

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: On 11-Dec-2010: Antistreptolysin titre, 284 IU; Blood glucose, 583; IgM, 248 IU; IgE 233,9 IU; Antigiladin antibody, IgG 14 IU; Fasting blood glucose 264 mg; Blood immunoglobulin M, 248 IU; 12/11/2010, Streptococcus test, 284 IU
CDC 'Split Type': WAES1303ITA002329

Write-up:Case received from Health Authority (case n. 195155) on 04-MAR-2013 through SPMSD. Case initially reported by a physician. Case medically confirmed. An 11 year old female patient was vaccinated on 03-DEC-10 with the third dose of GARDASIL (batch n. NM06870, lot number NJ53440, expiration date 31-DEC-2011) i.m. On 05-DEC-10 she presented with polydypsia and polyuria. She was admitted to the hospital and diagnosed with diabetes mellitus and treated with insulin. Labwork performed: see lab comments screen. The outcome is not recovered. The case is closed.


Changed on 9/14/2017

486419 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Foreign
Vaccinated:2010-12-03
Onset:2010-12-05
Submitted:2013-03-07
Entered:2013-03-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. NJ53440 / 2 3 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Blood glucose increased, Blood immunoglobulin E increased, Blood immunoglobulin M increased, Diabetes mellitus, Polydipsia, Polyuria, Antibody test, Streptococcus test, Streptococcus test negative

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? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: No other medications
Current Illness: Unknown
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: On 11-Dec-2010: Antistreptolysin titre, 284 IU; Blood glucose, 583; IgM, 248 IU; IgE 233,9 IU; Antigiladin antibody, IgG 14 IU; Fasting blood glucose 264 mg; Blood immunoglobulin M, 248 IU; 12/11/2010, Streptococcus test, 284 IU
CDC 'Split Type': WAES1303ITA002329

Write-up:Case received from Health Authority (case n. 195155) on 04-MAR-2013 through SPMSD. Case initially reported by a physician. Case medically confirmed. An 11 year old female patient was vaccinated on 03-DEC-10 with the third dose of GARDASIL (batch n. NM06870, lot number NJ53440, expiration date 31-DEC-2011) i.m. On 05-DEC-10 she presented with polydypsia and polyuria. She was admitted to the hospital and diagnosed with diabetes mellitus and treated with insulin. Labwork performed: see lab comments screen. The outcome is not recovered. The case is closed.


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