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This is VAERS ID 274595

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274595
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - UN / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1974AB / - UN / -

Administered by: Other      Purchased by: Unknown
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type':

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the"time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of th


Changed on 12/8/2009

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / - UN / -
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U1974AB / - UN / -

Administered by: Other      Purchased by: Unknown Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': (blank) WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the"time the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''''s Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of th this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07.


Changed on 3/2/2010

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F 654535/0960F / - 0 UN / - IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U1974AB / - 0 UN / - IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 4/7/2010

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 1/4/2011

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 4/13/2011

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 5/13/2011

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 6/11/2011

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


Changed on 5/14/2017

VAERS ID: 274595 Before After
Age:14.0
Gender:Female
Location:Pennsylvania
Vaccinated:2006-12-20
Onset:2007-01-06
Submitted:2007-03-14
Entered:2007-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 654535/0960F / 0 UN / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U1974AB / 0 UN / IM

Administered by: Other      Purchased by: Other
Symptoms: Abdominal pain upper, Diarrhoea, Facial palsy, Herpes zoster oticus

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications:
Current Illness: Herpes on lip
Preexisting Conditions: UNK
Diagnostic Lab Data:
CDC 'Split Type': WAES0702USA04217

Write-up:Information has been received from a registered nurse concerning a 11 year old female who was vaccinated with a dose of Gardasil. Concomitant therapy administered at the same time at a different anatomical site included a dose of MENACTRA. Illness at the time of vaccination included herpes simplex on the lip. On 09-JAN-2007, the patient was seen in the office and was diagnosed with herpes zoster otitis which progressed to a diagnosis of Bell''s palsy and Rasmsay-Hunt Syndrome on 15-JAN-2007. At time of this report, the patient''s outcome was unknown. No product quality complaint was involved. Additional information has been requested. 03/28/07-records received for DOS 1/16/07 DX:Bell''s Palsy. Ramsay Hunt Syndrome. PH:1/9/07-Seen by PMD to treat shingles in right ear with acyclovir. TX stopped on 1/16/07 due to bells palsy. Right side facial droop difficulty eating. C/O headache thoughout with shingles. 1/16/07-stomach cramps, diarrhea. Symptoms resolved 2/8/07. Additional information is not expected.


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