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This is VAERS ID 513736

History of Changes from the VAERS Wayback Machine

First Appeared on 12/13/2013

513736
VAERS Form:
Age:14.0
Gender:Female
Location:Idaho
Vaccinated:2013-08-26
Onset:2013-09-12
Submitted:2013-11-19
Entered:2013-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H017698 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Full blood count normal, Headache, Loss of consciousness, Nausea, Activities of daily living impaired, Urine analysis normal

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: CBC = normal; Glucose levels = normal; EKG = normal; Chest X-ray = normal; B.P. = normal to low; No fever; U/A = normal
CDC 'Split Type':

Write-up:2 weeks after immunization blacked out during volleyball game and went to ER. Ongoing symptoms of dizziness, passing out, trouble breathing, nausea and headaches. Missing school and working with doctors to relieve symptoms. After 90 days, still having reactions.


Changed on 6/14/2014

513736 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Idaho
Vaccinated:2013-08-26
Onset:2013-09-12
Submitted:2013-11-19
Entered:2013-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H017698 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Full blood count normal, Headache, Loss of consciousness, Nausea, Activities of daily living impaired, Urine analysis normal

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: CBC = normal; Glucose levels = normal; EKG = normal; Chest X-ray = normal; B.P. = normal to low; No fever; U/A = normal
CDC 'Split Type':

Write-up:2 weeks after immunization blacked out during volleyball game and went to ER. Ongoing symptoms of dizziness, passing out, trouble breathing, nausea and headaches. Missing school and working with doctors to relieve symptoms. After 90 days, still having reactions.


Changed on 3/14/2015

513736 Before After
VAERS Form:
Age:14.0
Gender:Female
Location:Idaho
Vaccinated:2013-08-26
Onset:2013-09-12
Submitted:2013-11-19
Entered:2013-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H017698 / 0 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Full blood count normal, Headache, Loss of consciousness, Nausea, Activities of daily living impaired, Urine analysis normal

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: CBC = normal; Glucose levels = normal; EKG = normal; Chest X-ray = normal; B.P. = normal to low; No fever; U/A = normal
CDC 'Split Type':

Write-up:2 weeks after immunization blacked out during volleyball game and went to ER. Ongoing symptoms of dizziness, passing out, trouble breathing, nausea and headaches. Missing school and working with doctors to relieve symptoms. After 90 days, still having reactions.


Changed on 9/14/2017

513736 Before After
VAERS Form:(blank) 1
Age:14.0
Gender:Female
Location:Idaho
Vaccinated:2013-08-26
Onset:2013-09-12
Submitted:2013-11-19
Entered:2013-11-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H017698 / 0 1 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood glucose normal, Chest X-ray normal, Dizziness, Dyspnoea, Electrocardiogram normal, Full blood count normal, Headache, Loss of consciousness, Nausea, Activities of daily living impaired, Urine analysis normal

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: CBC = normal; Glucose levels = normal; EKG = normal; Chest X-ray = normal; B.P. = normal to low; No fever; U/A = normal
CDC 'Split Type':

Write-up:2 weeks after immunization blacked out during volleyball game and went to ER. Ongoing symptoms of dizziness, passing out, trouble breathing, nausea and headaches. Missing school and working with doctors to relieve symptoms. After 90 days, still having reactions.


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