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This is VAERS ID 685706

History of Changes from the VAERS Wayback Machine

First Appeared on 3/14/2017

685706
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2012-05-20
Onset:2012-05-30
Submitted:2017-03-13
Entered:2017-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 LA / SC

Administered by: Private      Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Epstein-Barr virus infection, Thyroxine, Tri-iodothyronine, Autoimmune thyroiditis, Epstein-Barr virus test, Antibody test

Life Threatening? Yes
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: 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.


Changed on 4/14/2017

685706 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Oregon
Vaccinated:2012-05-20 2012-08-16
Onset:2012-05-30 0000-00-00
Submitted:2017-03-13
Entered:2017-03-13
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0337Z / 0 AR / IM
HPVX: HPV (NO BRAND NAME) / UNKNOWN MANUFACTURER - / 3 LA / SC
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4098AB / 0 AR / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Epstein-Barr virus infection, Thyroxine, Tri-iodothyronine, Autoimmune thyroiditis, Epstein-Barr virus test, Antibody test

Life Threatening? Yes
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: 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.


Changed on 9/14/2017

685706 Before After
VAERS Form:(blank) 1
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 / 0 1 AR / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U4098AB / 0 1 AR / IM

Administered by: Private      Purchased by: Other
Symptoms: Blood thyroid stimulating hormone, Epstein-Barr virus infection, Thyroxine, Tri-iodothyronine, Autoimmune thyroiditis, Epstein-Barr virus test, Antibody test

Life Threatening? Yes
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: 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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