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This is VAERS ID 263032

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

263032
VAERS Form:
Age:16.0
Gender:Female
Location:Illinois
Vaccinated:2006-07-07
Onset:2006-07-20
Submitted:2006-08-24
Entered:2006-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, INC. U2069AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown
Symptoms: Asthenia, Dehydration, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness:
Preexisting Conditions: Attention deficit disorder.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine.


Changed on 12/8/2009

263032 Before After
VAERS Form:
Age:16.0 15.0
Gender:Female
Location:Illinois
Vaccinated:2006-07-07
Onset:2006-07-20
Submitted:2006-08-24
Entered:2006-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR, INC. SANOFI PASTEUR U2069AA / 0 UN / IM

Administered by: Private      Purchased by: Unknown Private
Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness:
Preexisting Conditions: Attention deficit disorder.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos. Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent. Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened. Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair. Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP. Exam showed definite weakness of all extremities, esp upper extremities, & neck. Reflexes were absent in legs. Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help. Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records. Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT. Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands. Now able to rise from sitting on floor w/o support. Still no reflexes in legs. Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss


Changed on 4/7/2010

263032 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-07-07
Onset:2006-07-20
Submitted:2006-08-24
Entered:2006-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2069AA / 0 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness:
Preexisting Conditions: Attention deficit disorder.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos. Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent. Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened. Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair. Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP. Exam showed definite weakness of all extremities, esp upper extremities, & neck. Reflexes were absent in legs. Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help. Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records. Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT. Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands. Now able to rise from sitting on floor w/o support. Still no reflexes in legs. Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss


Changed on 9/14/2017

263032 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Illinois
Vaccinated:2006-07-07
Onset:2006-07-20
Submitted:2006-08-24
Entered:2006-09-14
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0637F / 0 1 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2069AA / 0 1 UN / IM

Administered by: Private      Purchased by: Private
Symptoms: Asthenia, Dehydration, Difficulty in walking, Gait disturbance, Guillain-Barre syndrome, Laboratory test abnormal, Paraesthesia, Psychomotor hyperactivity

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 1     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall
Current Illness:
Preexisting Conditions: Attention deficit disorder.
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Guillain Barre. She was well on day of immunization but later said she was weak and several months this was not objectively noticed then, but shortly after the vaccine. 9/28/06 Received medical records from neurologists which reveal patient seen by PCP 7/31/06 with complaint of loss of strength over past 3 mos. Labs were done by PCP & showed mild dehydration & elevated neutrophils, eos were absent. Patient referred to neuro & initial eval on 8/3 reveals patient noted weakness beginning in June which had progressively worsened. Symptoms included tingling sensation at tip of fingers & significant weakness to the point she could not do her own hair. Birth history was WNL & only PMH is of ADD & has been on Adderall for about 1 year as well as BCP. Exam showed definite weakness of all extremities, esp upper extremities, & neck. Reflexes were absent in legs. Gait was normal but had difficulty taking steps w/o support & could not rise from sitting w/o help. Normal CPK made dx difficult & EMG/NCS was done on 8/4 which was strongly positive for GBS & copy of test included with records. Treated with IVIG x 2 days & placed in rehab facility on 8/5/06 for eval & therapy then received home PT. Seen by neuro next on 8/24 which showed improvement but still with weakness especially in the hands. Now able to rise from sitting on floor w/o support. Still no reflexes in legs. Complete but slow recovery was expected at that time/ss 9/28/06 Received medical records from hospital which reveal patient admitted 8/4/-8/6/06 for IVIG & PT./ss


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