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This is VAERS ID 268017

History of Changes from the VAERS Wayback Machine

First Appeared on 12/30/2006

268017
VAERS Form:
Age:16.0
Gender:Female
Location:Tennessee
Vaccinated:0000-00-00
Onset:0000-00-00
Submitted:2006-11-29
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient developed jerking in upper extremity a few hours after administration of vaccine. Patient was medicated with VALIUM which led to resolution of symptoms.


Changed on 12/8/2009

268017 Before After
VAERS Form:
Age:16.0
Gender:Female
Location:Tennessee
Vaccinated:0000-00-00 2006-09-27
Onset:0000-00-00 2006-09-27
Submitted:2006-11-29
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HUMAN PAPILLOMAVIRUS RECOMBINANT VACCINE, QUADRIVALENT (GARDASIL) HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient developed jerking in upper extremity a few hours after administration of vaccine. Patient was medicated with VALIUM which led to resolution of symptoms.


Changed on 9/14/2017

268017 Before After
VAERS Form:(blank) 1
Age:16.0
Gender:Female
Location:Tennessee
Vaccinated:2006-09-27
Onset:2006-09-27
Submitted:2006-11-29
Entered:2006-11-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0955F / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Dyskinesia

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? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Patient developed jerking in upper extremity a few hours after administration of vaccine. Patient was medicated with VALIUM which led to resolution of symptoms.


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