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This is VAERS ID 567058

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2015

567058
VAERS Form:
Age:11.0
Gender:Female
Location:Oregon
Vaccinated:2009-07-16
Onset:2009-07-24
Submitted:2015-02-25
Entered:2015-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1497X / 0 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2918AA / 0 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3158AA / 0 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Dizziness, Fatigue, Hypothyroidism, Nausea, Autoimmune thyroiditis, Tilt table test, Thyroxine free, 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: 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).


Changed on 9/14/2017

567058 Before After
VAERS Form:(blank) 1
Age:11.0
Gender:Female
Location:Oregon
Vaccinated:2009-07-16
Onset:2009-07-24
Submitted:2015-02-25
Entered:2015-02-25
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 1497X / 0 1 RA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2918AA / 0 1 RA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR C3158AA / 0 1 LA / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Dizziness, Fatigue, Hypothyroidism, Nausea, Autoimmune thyroiditis, Tilt table test, Thyroxine free, 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: 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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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=567058&WAYBACKHISTORY=ON


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