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This is VAERS ID 265839

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

265839
VAERS Form:
Age:16.0
Gender:Female
Location:Ohio
Vaccinated:0000-00-00
Onset:2006-10-09
Submitted:2006-10-30
Entered:2006-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. - / 0 UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Asthenia, Guillain-Barre syndrome, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a physician concerning a 16 year old female who on an unspecified date was vaccinated with the first dose of HPV vaccine. subsequently the pt developed lower extremity weakness and was hospitalized for two days with Guil"lain Barre. The pt received treatment with gamma globulin during her hospitalization. At the time of this report, the pt was back to school and was 99% recovered having only some area of numbness to her lower extremities. The physician did not believe tha


Changed on 12/8/2009

265839 Before After
VAERS Form:
Age:16.0 17.0
Gender:Female
Location:Ohio
Vaccinated:0000-00-00 2006-09-20
Onset:2006-10-09
Submitted:2006-10-30
Entered:2006-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. - 0954F / 0 UN / - UN

Administered by: Other      Purchased by: Unknown Other
Symptoms: Asthenia, Back pain, Electromyogram abnormal, Guillain-Barre syndrome, Hypoaesthesia, Musculoskeletal pain, Neck pain, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/12/06-records received-EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibila nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre
CDC 'Split Type': (blank) WAES0610USA11542

Write-up:Information has been received from a physician concerning a 16 year old female who on an unspecified date was vaccinated with the first dose of HPV vaccine. subsequently the pt developed lower extremity weakness and was hospitalized for two days with Guil"lain Guillain Barre. The pt received treatment with gamma globulin during her hospitalization. At the time of this report, the pt was back to school and was 99% recovered having only some area of numbness to her lower extremities. The physician did not believe tha that the pt was on any other medications at the time and had no further details to provide. Additional information has been requested. Mild Guillane Barre Syndrome. EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibial nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre Syndrome. 12/12/06-records received from facility. DX Mild Guillain Barre Syndrome. 12/28/06-DC Summary received DC DX: Mild Guillain Barre Syndrome. 1.5 week duration of tingling below kness and above ankle bilaterally. Pain with walking. Office note for DO 12/28/06 from pediatric neurologist:continues to have tingling from elbow to hands, improving. On Neurontin 100 mg tabs 1 three times per day. Has pain across shoulders and neck also lower back. Will order labs.


Changed on 5/14/2017

265839 Before After
VAERS Form:
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2006-09-20
Onset:2006-10-09
Submitted:2006-10-30
Entered:2006-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Back pain, Electromyogram abnormal, Hypoaesthesia, Musculoskeletal pain, Neck pain, Paraesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/12/06-records received-EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibila nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre Syndrome. Glucose on 9/30/06 148, albumin 30, CK 30.
CDC 'Split Type': WAES0610USA11542

Write-up:Information has been received from a physician concerning a 16 year old female who on an unspecified date was vaccinated with the first dose of HPV vaccine. subsequently the pt developed lower extremity weakness and was hospitalized for two days with Guillain Barre. [[name]]. The pt received treatment with gamma globulin during her hospitalization. At the time of this report, the pt was back to school and was 99% recovered having only some area of numbness to her lower extremities. The physician did not believe that the pt was on any other medications at the time and had no further details to provide. Additional information has been requested. Mild Guillane Barre [[name]] Syndrome. EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibial nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre [[name]] Syndrome. 12/12/06-records received from facility. DX Mild Guillain Barre [[name]] Syndrome. 12/28/06-DC Summary received DC DX: Mild Guillain Barre [[name]] Syndrome. 1.5 week duration of tingling below kness and above ankle bilaterally. Pain with walking. Office note for DO 12/28/06 from pediatric neurologist:continues to have tingling from elbow to hands, improving. On Neurontin 100 mg tabs 1 three times per day. Has pain across shoulders and neck also lower back. Will order labs.


Changed on 9/14/2017

265839 Before After
VAERS Form:(blank) 1
Age:17.0
Gender:Female
Location:Ohio
Vaccinated:2006-09-20
Onset:2006-10-09
Submitted:2006-10-30
Entered:2006-11-02
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0954F / 0 1 UN / UN

Administered by: Other      Purchased by: Other
Symptoms: Asthenia, Hypoaesthesia

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: UNK
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 12/12/06-records received-EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibila nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain Barre Syndrome. Glucose on 9/30/06 148, albumin 30, CK 30.
CDC 'Split Type': WAES0610USA11542

Write-up:Information has been received from a physician concerning a 16 year old female who on an unspecified date was vaccinated with the first dose of HPV vaccine. subsequently the pt developed lower extremity weakness and was hospitalized for two days with Guillain [[name]]. The pt received treatment with gamma globulin during her hospitalization. At the time of this report, the pt was back to school and was 99% recovered having only some area of numbness to her lower extremities. The physician did not believe that the pt was on any other medications at the time and had no further details to provide. Additional information has been requested. Mild Guillane [[name]] Syndrome. EMG study on 10/10/2006: nerve conduction studies of right peroneal and tibial nerves were normal. F wave latencies were normal but some blocking was present. Conclusion: study consistent with mild Guillain [[name]] Syndrome. 12/12/06-records received from facility. DX Mild Guillain [[name]] Syndrome. 12/28/06-DC Summary received DC DX: Mild Guillain [[name]] Syndrome. 1.5 week duration of tingling below kness and above ankle bilaterally. Pain with walking. Office note for DO 12/28/06 from pediatric neurologist:continues to have tingling from elbow to hands, improving. On Neurontin 100 mg tabs 1 three times per day. Has pain across shoulders and neck also lower back. Will order labs.


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