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This is VAERS ID 536061

History of Changes from the VAERS Wayback Machine

First Appeared on 7/14/2014

536061
VAERS Form:
Age:11.0
Gender:Female
Location:Michigan
Vaccinated:2011-08-15
Onset:2011-09-13
Submitted:2014-07-07
Entered:2014-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4031AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3927BA / 5 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Blood lactate dehydrogenase increased, Dermatomyositis, Fatigue, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Rash, X-ray, Muscle contracture, Antinuclear antibody increased, Immunoglobulin therapy

Life Threatening? Yes
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: 60     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Elevated CK, LDH, ANA; Xrays; MRI - confirmation of dermatomyositis in thighs
CDC 'Split Type':

Write-up:9-13-2011 Appearance of "rash" - on face and chest treated with oral steroids and antihistamine. 9-25-2011 Rash still present. Treated with more prednisone. Nov - Dec 2011 - Treated with topicals; Jan 2012 more topicals. June 2012 muscle contractures, rash, fatigue, muscle weakness. July 2012 - Dermatomyositis - prednisone, SOLUMEDROL, IVIG, CELLCEPT.


Changed on 8/14/2014

536061 Before After
VAERS Form:
Age:11.0
Gender:Female
Location:Michigan
Vaccinated:2011-08-15
Onset:2011-09-13
Submitted:2014-07-07
Entered:2014-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4031AA / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3927BA / 5 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Blood lactate dehydrogenase increased, Dermatomyositis, Fatigue, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Rash, X-ray, Muscle contracture, Antinuclear antibody increased, Immunoglobulin therapy

Life Threatening? Yes
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: 60 28     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Elevated CK, LDH, ANA; Xrays; MRI - confirmation of dermatomyositis in thighs
CDC 'Split Type':

Write-up:9-13-2011 Appearance of "rash" - on face and chest treated with oral steroids and antihistamine. 9-25-2011 Rash still present. Treated with more prednisone. Nov - Dec 2011 - Treated with topicals; Jan 2012 more topicals. June 2012 muscle contractures, rash, fatigue, muscle weakness. July 2012 - Dermatomyositis - prednisone, SOLUMEDROL, IVIG, CELLCEPT.


Changed on 9/14/2017

536061 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Michigan
Vaccinated:2011-08-15
Onset:2011-09-13
Submitted:2014-07-07
Entered:2014-07-08
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0841AA / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4031AA / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3927BA / 5 6 LA / IM

Administered by: Private      Purchased by: Private
Symptoms: Blood creatine phosphokinase increased, Blood lactate dehydrogenase increased, Dermatomyositis, Fatigue, Muscular weakness, Nuclear magnetic resonance imaging abnormal, Rash, X-ray, Muscle contracture, Antinuclear antibody increased, Immunoglobulin therapy

Life Threatening? Yes
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: 28     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Elevated CK, LDH, ANA; Xrays; MRI - confirmation of dermatomyositis in thighs
CDC 'Split Type':

Write-up:9-13-2011 Appearance of "rash" - on face and chest treated with oral steroids and antihistamine. 9-25-2011 Rash still present. Treated with more prednisone. Nov - Dec 2011 - Treated with topicals; Jan 2012 more topicals. June 2012 muscle contractures, rash, fatigue, muscle weakness. July 2012 - Dermatomyositis - prednisone, SOLUMEDROL, IVIG, CELLCEPT.


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