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This is VAERS ID 632624

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2016

632624
VAERS Form:
Age:15.0
Gender:Male
Location:Washington
Vaccinated:2015-06-25
Onset:2015-06-25
Submitted:2016-04-23
Entered:2016-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 0 UN / SYR

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Dizziness, Fatigue, Headache, Malaise, Muscular weakness, Nausea, Pain in extremity, Vomiting, X-ray, X-ray with contrast upper gastrointestinal tract, Activities of daily living impaired, Blood test

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness: Yearly physical
Preexisting Conditions: Ulcer
Allergies:
Diagnostic Lab Data: X-rays, upper GI, blood work
CDC 'Split Type':

Write-up:Vomting, joints hurt, frequent headaches, general feeling of unwell, feeling dizzy, painful hands, feet, arms, legs, nausea, muscle weakness, tiredness, missing more school from not feeling good.


Changed on 9/14/2017

632624 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Male
Location:Washington
Vaccinated:2015-06-25
Onset:2015-06-25
Submitted:2016-04-23
Entered:2016-04-23
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. K006960 / 0 1 UN / SYR

Administered by: Private      Purchased by: Other
Symptoms: Arthralgia, Dizziness, Fatigue, Headache, Malaise, Muscular weakness, Nausea, Pain in extremity, Vomiting, X-ray, X-ray with contrast upper gastrointestinal tract, Activities of daily living impaired, Blood test

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: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Omeprazole
Current Illness: Yearly physical
Preexisting Conditions: Ulcer
Allergies:
Diagnostic Lab Data: X-rays, upper GI, blood work
CDC 'Split Type':

Write-up:Vomting, joints hurt, frequent headaches, general feeling of unwell, feeling dizzy, painful hands, feet, arms, legs, nausea, muscle weakness, tiredness, missing more school from not feeling good.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=632624&WAYBACKHISTORY=ON


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