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This is VAERS ID 692487

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2017

692487
VAERS Form:
Age:10.0
Gender:Female
Location:California
Vaccinated:2013-10-24
Onset:2013-10-24
Submitted:2017-04-26
Entered:2017-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 0 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 74AP3 / 1 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Abdominal pain upper, Back pain, Headache, Menorrhagia, Pelvic pain, Rash, Laboratory 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Born with a tethered cord
Allergies:
Diagnostic Lab Data: Years of testing and hospitalization.
CDC 'Split Type':

Write-up:Headache day of vaccine and rash. Pain in her back, stomach, pelvis. Periods lasting weeks at a time and heavy. Back pain is constant.


Changed on 9/14/2017

692487 Before After
VAERS Form:(blank) 1
Age:10.0
Gender:Female
Location:California
Vaccinated:2013-10-24
Onset:2013-10-24
Submitted:2017-04-26
Entered:2017-04-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. H020002 / 0 1 LA / IM
TDAP: TDAP (ADACEL) / SANOFI PASTEUR 74AP3 / 1 2 RA / IM

Administered by: Private      Purchased by: Other
Symptoms: Abdominal pain upper, Back pain, Headache, Menorrhagia, Pelvic pain, Rash, Laboratory 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:     Extended hospital stay? Yes
Previous Vaccinations:
Other Medications:
Current Illness: None
Preexisting Conditions: Born with a tethered cord
Allergies:
Diagnostic Lab Data: Years of testing and hospitalization.
CDC 'Split Type':

Write-up:Headache day of vaccine and rash. Pain in her back, stomach, pelvis. Periods lasting weeks at a time and heavy. Back pain is constant.


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http://www.medalerts.org/vaersdb/findfield.php?IDNUMBER=692487&WAYBACKHISTORY=ON


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