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This is VAERS ID 510201

History of Changes from the VAERS Wayback Machine

First Appeared on 11/13/2013

510201
VAERS Form:
Age:16.0
Gender:Male
Location:Virginia
Vaccinated:2012-07-31
Onset:2012-11-14
Submitted:2013-10-29
Entered:2013-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 0 - / -

Administered by: Private      Purchased by: Other
Symptoms: Depression, Fatigue, Hypotension, Lethargy, Postural orthostatic tachycardia syndrome

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:
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: POTS and NMH
CDC 'Split Type':

Write-up:Lethargy, extreme fatigue, depression.


Changed on 3/14/2014

510201 Before After
VAERS Form:
Age:16.0
Gender:Male
Location:Virginia
Vaccinated:2012-07-31 2012-09-18
Onset:2012-11-14
Submitted:2013-10-29
Entered:2013-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - H014231 / 0 1 - LA / - IM

Administered by: Private      Purchased by: Other
Symptoms: Depression, Fatigue, Hypotension, Lethargy, Postural orthostatic tachycardia syndrome

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 Yes
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: POTS and NMH
CDC 'Split Type':

Write-up:Lethargy, extreme fatigue, depression.


Changed on 9/14/2017

510201 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Male
Location:Virginia
Vaccinated:2012-09-18
Onset:2012-11-14
Submitted:2013-10-29
Entered:2013-10-29
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H014231 / 1 2 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Depression, Fatigue, Hypotension, Lethargy, Postural orthostatic tachycardia syndrome

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:
Current Illness:
Preexisting Conditions: Penicillin
Allergies:
Diagnostic Lab Data: POTS and NMH
CDC 'Split Type':

Write-up:Lethargy, extreme fatigue, depression.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=510201&WAYBACKHISTORY=ON


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