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This is VAERS ID 646617

History of Changes from the VAERS Wayback Machine

First Appeared on 10/14/2016

646617
VAERS Form:
Age:13.0
Gender:Female
Location:Colorado
Vaccinated:2014-08-12
Onset:2015-03-01
Submitted:2016-08-05
Entered:2016-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H021346 / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M12122 / 0 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B092FA / 0 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Fatigue, Headache, Laboratory test abnormal, Immune thrombocytopenic purpura

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Abnormal
CDC 'Split Type':

Write-up:C/O headache increased fatigue, weakness. Developed Idiopathic thrombocytopenic purpura (ITP).


Changed on 9/14/2017

646617 Before After
VAERS Form:(blank) 1
Age:13.0
Gender:Female
Location:Colorado
Vaccinated:2014-08-12
Onset:2015-03-01
Submitted:2016-08-05
Entered:2016-08-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H021346 / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENVEO) / NOVARTIS VACCINES AND DIAGNOSTICS M12122 / 0 1 RA / IM
TDAP: TDAP (BOOSTRIX) / GLAXOSMITHKLINE BIOLOGICALS AC52B092FA / 0 1 LA / IM

Administered by: Public      Purchased by: Public
Symptoms: Asthenia, Fatigue, Headache, Laboratory test abnormal, Immune thrombocytopenic purpura

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies:
Diagnostic Lab Data: Abnormal
CDC 'Split Type':

Write-up:C/O headache increased fatigue, weakness. Developed Idiopathic thrombocytopenic purpura (ITP).


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=646617&WAYBACKHISTORY=ON


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