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This is VAERS ID 685706

Case Details

VAERS ID: 685706 (history)  
Form: Version 1.0  
Age: 16.0  
Gender: Female  
Location: Oregon  
Vaccinated:2012-08-16
Onset:0000-00-00
Submitted: 2017-03-13
Entered: 2017-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0337Z / 1 AR / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4098AB / 1 AR / IM

Administered by: Private       Purchased by: Other
Symptoms: Antibody test, Autoimmune thyroiditis, Blood thyroid stimulating hormone, Epstein-Barr virus infection, Epstein-Barr virus test, Thyroxine, Tri-iodothyronine
SMQs:, Hypothyroidism (broad), Hyperthyroidism (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad)

Life Threatening? Yes
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: Type 1 Diabetes~HPV (no brand name)~2~16.00~Sibling|Vitiligo~HPV (no brand name)~3~13.00~Sibling
Other Medications: Albuterol only on occassion
Current Illness: No illness
Preexisting Conditions: Asthma
Allergies:
Diagnostic Lab Data: TSH, T3, T4 blood tests as well as antibodies that showed over 1000. EBV test performed
CDC Split Type:

Write-up: Hashimoto''s Thyroiditis. No prior history. Also diagnosed with EBV.


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