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This is VAERS ID 499046

History of Changes from the VAERS Wayback Machine

First Appeared on 8/12/2013

499046
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2012-04-01
Onset:2012-05-01
Submitted:2013-08-11
Entered:2013-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Alopecia, Back pain, Biopsy, Dizziness, Nausea, Ultrasound abdomen, Blood 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Allergies:
Diagnostic Lab Data: Blood Labs, abdominal ultrasound, scalp biopsy
CDC 'Split Type':

Write-up:Hair loss, stomach pains, back pains, nausea, dizziness.


Changed on 9/17/2013

499046 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2012-04-01
Onset:2012-05-01
Submitted:2013-08-11
Entered:2013-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Alopecia, Back pain, Biopsy, Biopsy skin abnormal, Dizziness, Nausea, Ultrasound abdomen, Blood test, Androgenetic alopecia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO The following information was obtained through follow-up and/or provided by the government. 8/26/13 Diaper rash, seizures. Seborrheic dermatitis.
Allergies:
Diagnostic Lab Data: Blood Labs, abdominal ultrasound, scalp biopsy The following information was obtained through follow-up and/or provided by the government. 8/26/13 Labs and Diagnostics: Punch Biopsy Skin - Abnormal.
CDC 'Split Type':

Write-up:Hair loss, stomach pains, back pains, nausea, dizziness. The following information was obtained through follow-up and/or provided by the government. 8/26/13 PCP Medical records received. Service dates 8/21/96 to 12/12/12. Diagnosis: Androgenic Alopecia. Parent relates start of hear loss to same time as 2nd HPV vaccine. Referral to dermatologist.


Changed on 3/14/2015

499046 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:California
Vaccinated:2012-04-01
Onset:2012-05-01
Submitted:2013-08-11
Entered:2013-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Alopecia, Back pain, Biopsy, Biopsy skin abnormal, Dizziness, Nausea, Ultrasound abdomen, Blood test, Androgenetic alopecia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO The following information was obtained through follow-up and/or provided by the government. 8/26/13 Diaper rash, seizures. Seborrheic dermatitis.
Allergies:
Diagnostic Lab Data: Blood Labs, abdominal ultrasound, scalp biopsy The following information was obtained through follow-up and/or provided by the government. 8/26/13 Labs and Diagnostics: Punch Biopsy Skin - Abnormal.
CDC 'Split Type':

Write-up:Hair loss, stomach pains, back pains, nausea, dizziness. The following information was obtained through follow-up and/or provided by the government. 8/26/13 PCP Medical records received. Service dates 8/21/96 to 12/12/12. Diagnosis: Androgenic Alopecia. Parent relates start of hear loss to same time as 2nd HPV vaccine. Referral to dermatologist.


Changed on 9/14/2017

499046 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:California
Vaccinated:2012-04-01
Onset:2012-05-01
Submitted:2013-08-11
Entered:2013-08-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 2 3 - / -

Administered by: Private      Purchased by: Private
Symptoms: Abdominal pain upper, Alopecia, Back pain, Biopsy, Dizziness, Nausea, Ultrasound abdomen, Blood 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)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: NO
Preexisting Conditions: NO
Allergies:
Diagnostic Lab Data: Blood Labs, abdominal ultrasound, scalp biopsy
CDC 'Split Type':

Write-up:Hair loss, stomach pains, back pains, nausea, dizziness.


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