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This is VAERS ID 567058

Case Details

VAERS ID: 567058 (history)  
Form: Version 1.0  
Age: 11.0  
Gender: Female  
Location: Oregon  
Vaccinated:2009-07-16
Onset:2009-07-24
   Days after vaccination:8
Submitted: 2015-02-25
   Days after onset:2042
Entered: 2015-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1497X / 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2918AA / 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3158AA / 1 LA / IM

Administered by: Private       Purchased by: Other
Symptoms: Autoimmune thyroiditis, Blood thyroid stimulating hormone, Dizziness, Fatigue, Hypothyroidism, Nausea, Postural orthostatic tachycardia syndrome, Thyroxine free, Tilt table test
SMQs:, Acute pancreatitis (broad), Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Hypothyroidism (narrow), Hyperthyroidism (broad), Vestibular disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Dizziness; Nausea
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: TSH, Free T4 and Tilt test
CDC Split Type:

Write-up: Dizziness, nausea, fatigue. Got hypothyroid Hashimoto''s and POTS shortly after (diagnosed).


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