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This is VAERS ID 274336

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

274336
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, CSF test normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facil"ity for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest


Changed on 12/8/2009

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facil"ity facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 4/7/2010

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 8/31/2010

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 4/13/2011

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 5/13/2011

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 6/11/2011

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 2/14/2017

274336 Before After
VAERS Form:
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2136AA / 0 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest pain, Chest X-ray normal, Cough, Electrocardiogram normal, Extensor plantar response, Full blood count normal, Gait disturbance, Guillain-Barre syndrome, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


Changed on 9/14/2017

274336 Before After
VAERS Form:(blank) 1
Age:15.0
Gender:Female
Location:Louisiana
Vaccinated:2007-02-28
Onset:2007-03-01
Submitted:2007-03-19
Entered:2007-03-19
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 1 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2136AA / 0 1 LA / IM

Administered by: Unknown      Purchased by: Unknown
Symptoms: Blood glucose normal, Chest X-ray normal, Full blood count normal, Headache, Hypoaesthesia, Hypokinesia, Hyporeflexia, Malaise, Pyrexia, Tremor, Vomiting, CSF test normal, Urine analysis normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? Yes
ER or ED Visit? (V2.0) No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Icar, Advair
Current Illness: none
Preexisting Conditions: none
Allergies:
Diagnostic Lab Data: CBC-wnl, Chest x-ray-wnl, glucose-wnl, urine-wnl, spinal fluid- wnl, MS eval-wnl records received 3/20/07-CSF did not show elevated protein level. CXR:normal EKG normal.
CDC 'Split Type':

Write-up:The next day after recieving Gardasil and Menactra vaccines pt began to have fever and vomiting as well as headache. On the second day after vaccination she began to experience right hand tremor and left foot numbness. 03/20/07-records received from facility for DOS 3/6-3/9/07. DC DX: Mild Guillain Barre Syndrome status post intravenous immune globulin. Developed subjective fever and feeling ill as well as vomiting. Started having numbness of left foot shaking of right hand and headache. C/O initial chest pain with cough.Suspected Guillain Barre and treatment included immune globulin. Neuro consult plan included IVIG. PE:WNL except for not able to dorsiflex or plantar flex at all as well as limitation although some movement of toes with active motion. Did not elicit ankle jerk at the left. Toes were downgoing on Babinski. Gait slightly unsteady


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