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This is VAERS ID 267171

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

VAERS ID: 267171
Age:13.0
Gender:Female
Location:Minnesota
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2006-11-17
Entered:2006-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) / AVENTIS PASTEUR, INC. U2244AA / 1 LA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 08668F / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to m"ove right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration.


Changed on 12/8/2009

VAERS ID: 267171 Before After
Age:13.0
Gender:Female
Location:Minnesota
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2006-11-17
Entered:2006-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (FLUZONE) INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR, INC. AVENTIS PASTEUR U2244AA / 1 LA / IM
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 08668F / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to m"ove move right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration. Received MR from pediatrician revealing a healthy 12 year old in for well-child exam. 24 hours after Flu and Gardasil vax. child developed numbness, pain, and inability to move the right side of face. Assessment: Facial Nerve Palsy-unclear etiology. Child was sent by car to Minneapolis Children''s ER to be evaluated. ER report received: DX: Bell''s Palsy


Changed on 7/7/2013

VAERS ID: 267171 Before After
Age:13.0
Gender:Female
Location:Minnesota
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2006-11-17
Entered:2006-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2244AA / 1 LA / IM
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR U2244AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08668F / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to move right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration. Received MR from pediatrician revealing a healthy 12 year old in for well-child exam. 24 hours after Flu and Gardasil vax. child developed numbness, pain, and inability to move the right side of face. Assessment: Facial Nerve Palsy-unclear etiology. Child was sent by car to Minneapolis Children''s ER to be evaluated. ER report received: DX: Bell''s Palsy


Changed on 5/14/2017

VAERS ID: 267171 Before After
Age:13.0
Gender:Female
Location:Minnesota
Vaccinated:2006-11-10
Onset:2006-11-11
Submitted:2006-11-17
Entered:2006-11-17
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
FLU3: INFLUENZA (SEASONAL) (FLUZONE) / AVENTIS PASTEUR SANOFI PASTEUR U2244AA / 1 LA / IM
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 08668F / 0 RA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Facial palsy, Hypoaesthesia, Pain, Paralysis

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: NONE
Current Illness: none
Preexisting Conditions: none
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:INfluenza vaccine and Human Papilloma VIrus vaccines given November 10 about 11:45 AM. Patient woke up with numbness on right side of face on November 11. Presented to Emergency Room on November 12 with Bells Palsy of right side of face. Unable to move right side of face. Unable to close right eye. Previously healthy, no symptoms on day of vaccine administration. Received MR from pediatrician revealing a healthy 12 year old in for well-child exam. 24 hours after Flu and Gardasil vax. child developed numbness, pain, and inability to move the right side of face. Assessment: Facial Nerve Palsy-unclear etiology. Child was sent by car to Minneapolis Children''s ER to be evaluated. ER report received: DX: Bell''s Palsy


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