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This is VAERS ID 607052

History of Changes from the VAERS Wayback Machine

First Appeared on 11/14/2015

607052
VAERS Form:
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2013-10-31
Onset:0000-00-00
Submitted:2015-11-03
Entered:2015-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020901 / 2 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4556AB / 0 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0505M / 0 UN / UN

Administered by: Public      Purchased by: Private
Symptoms: Impaired gastric emptying, Postural orthostatic tachycardia syndrome, Complex regional pain 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? Yes, days: 17     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: VSD, asthma
Allergies:
Diagnostic Lab Data: Having an EEG and gastric emptying study
CDC 'Split Type':

Write-up:Developed CRPS, POTS, gastroparesis ongoing.


Changed on 9/14/2017

607052 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Illinois
Vaccinated:2013-10-31
Onset:0000-00-00
Submitted:2015-11-03
Entered:2015-11-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020901 / 2 3 UN / UN
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4556AB / 0 1 UN / UN
VARCEL: VARICELLA (VARIVAX) / MERCK & CO. INC. 0505M / 0 1 UN / UN

Administered by: Public      Purchased by: Private
Symptoms: Impaired gastric emptying, Postural orthostatic tachycardia syndrome, Complex regional pain 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? Yes, days: 17     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: VSD, asthma
Allergies:
Diagnostic Lab Data: Having an EEG and gastric emptying study
CDC 'Split Type':

Write-up:Developed CRPS, POTS, gastroparesis ongoing.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=607052&WAYBACKHISTORY=ON


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