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This is VAERS ID 274953

History of Changes from the VAERS Wayback Machine

First Appeared on 12/31/2007

VAERS ID: 274953
Age:18.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-06
Onset:2007-03-07
Submitted:0000-00-00
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR U2115AA / 0 RA / IM

Administered by: Other      Purchased by: Unknown
Symptoms: Back pain, Blood culture negative, Body temperature, Bronchitis

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: Done in hospital
CDC 'Split Type':

Write-up:1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged f"acility 3/9/07.


Changed on 12/8/2009

VAERS ID: 274953 Before After
Age:18.0 17.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-06
Onset:2007-03-07
Submitted:0000-00-00
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) / AVENTIS PASTEUR SANOFI PASTEUR U2115AA / 0 RA / IM

Administered by: Other      Purchased by: Unknown Public
Symptoms: Back pain, Blood culture negative, Body temperature, Bronchitis, C-reactive protein increased, Convulsion, Culture urine negative, Discomfort, Dizziness, Electroencephalogram abnormal, Fall, Headache, Hyperventilation, Lack of spontaneous speech, Lumbar puncture, Nuclear magnetic resonance imaging brain, Nystagmus, Pyrexia, Stridor, Syncope, Tetany, Viral infection, Mental status changes, Red blood cell sedimentation rate increased, CSF test normal, Influenza serology negative, Scan brain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: Done in hospital LP: clear fluid, 1 WBC, 0 RBC, Glucose WNL at 56, protein 19. WBC 16.3, 90% neutrophil. Influenza A and B negative. EEG: mildly abnormal EEG due to excessive presence of beta activity which could be drug related. The lack
CDC 'Split Type':

Write-up:1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged f"acility facility 3/9/07. 04/02/07-records received from facility-Fever and altered neurological status. Temp 101.2. Fell at clinic. Fainted. Presented to ER with nystagmus with mainly her gaze toward the right. Not speaking Hyperventilating. Fever a few days ago and had been sick with viral syndrome. PE pupils equal round reactive to light but she had nystagmus frequently every few seconds and mainly seemed with a right. Required interpreter but she had no spontaneous speech. Carpal pedal spasm. Summary for DOS 3/7-3/9/07. DC DX:Diseases disorders of nervous system. Convulsions, Tetany, bronchitis, nystagmus, altered mental status, hyperventilation, headache, lumbago, fever. 8/25/08-progress notes received-3/8/07 all symptoms have resolved discharged without any medications. Continues to experience being a little dizzy when walking.


Changed on 4/7/2010

VAERS ID: 274953 Before After
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-06
Onset:2007-03-07
Submitted:0000-00-00
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL (MENACTRA) MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 0 RA / IM

Administered by: Other      Purchased by: Public
Symptoms: Back pain, Blood culture negative, Body temperature, Bronchitis, C-reactive protein increased, Convulsion, Culture urine negative, Discomfort, Dizziness, Electroencephalogram abnormal, Fall, Headache, Hyperventilation, Lack of spontaneous speech, Lumbar puncture, Nuclear magnetic resonance imaging brain, Nystagmus, Pyrexia, Stridor, Syncope, Tetany, Viral infection, Mental status changes, Red blood cell sedimentation rate increased, CSF test normal, Influenza serology negative, Scan brain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: Done in hospital LP: clear fluid, 1 WBC, 0 RBC, Glucose WNL at 56, protein 19. WBC 16.3, 90% neutrophil. Influenza A and B negative. EEG: mildly abnormal EEG due to excessive presence of beta activity which could be drug related. The lack
CDC 'Split Type':

Write-up:1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged facility 3/9/07. 04/02/07-records received from facility-Fever and altered neurological status. Temp 101.2. Fell at clinic. Fainted. Presented to ER with nystagmus with mainly her gaze toward the right. Not speaking Hyperventilating. Fever a few days ago and had been sick with viral syndrome. PE pupils equal round reactive to light but she had nystagmus frequently every few seconds and mainly seemed with a right. Required interpreter but she had no spontaneous speech. Carpal pedal spasm. Summary for DOS 3/7-3/9/07. DC DX:Diseases disorders of nervous system. Convulsions, Tetany, bronchitis, nystagmus, altered mental status, hyperventilation, headache, lumbago, fever. 8/25/08-progress notes received-3/8/07 all symptoms have resolved discharged without any medications. Continues to experience being a little dizzy when walking.


Changed on 5/14/2017

VAERS ID: 274953 Before After
Age:17.0
Gender:Female
Location:Arizona
Vaccinated:2007-03-06
Onset:2007-03-07
Submitted:0000-00-00
Entered:2007-03-27
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. 0960F / 0 LA / IM
MNQ: MENINGOCOCCAL CONJUGATE (MENACTRA) / SANOFI PASTEUR U2115AA / 0 RA / IM

Administered by: Other      Purchased by: Public
Symptoms: Back pain, Blood culture negative, Body temperature, Bronchitis, C-reactive protein increased, Convulsion, Culture urine negative, Discomfort, Dizziness, Electroencephalogram abnormal, Fall, Headache, Hyperventilation, Lack of spontaneous speech, Lumbar puncture, Nuclear magnetic resonance imaging brain, Nystagmus, Pyrexia, Stridor, Syncope, Tetany, Viral infection, Mental status changes, Red blood cell sedimentation rate increased, CSF test normal, Influenza serology negative, Scan brain

Life Threatening? No
Died? No
Permanent Disability? No
Recovered? Yes
ER or Doctor Visit? Yes
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness: Very minimal URI symptoms
Preexisting Conditions:
Diagnostic Lab Data: Done in hospital LP: clear fluid, 1 WBC, 0 RBC, Glucose WNL at 56, protein 19. WBC 16.3, 90% neutrophil. Influenza A and B negative. EEG: mildly abnormal EEG due to excessive presence of beta activity which could be drug related. The lack of epileptiform activity does not rule out seizure condition. MRI Brain: no evidence of acute intracranial hemorrhage. Bilateral small middle cranial fossa arachnoid cysts. No evidence of infarct. CT Brain:negative. C-reactive protein 6.99. Blood culture negative.urine culture negative. ESR elevated.
CDC 'Split Type':

Write-up:1:30 Backache, headache, dizziness, generalized discomfort in clinic - call to facility for clarification of side effects, referred to Family Practice - developed stridor, nystagmus - transferred to facility reported at 4:30. Admitted to ICU. Discharged facility 3/9/07. 04/02/07-records received from facility-Fever and altered neurological status. Temp 101.2. Fell at clinic. Fainted. Presented to ER with nystagmus with mainly her gaze toward the right. Not speaking Hyperventilating. Fever a few days ago and had been sick with viral syndrome. PE pupils equal round reactive to light but she had nystagmus frequently every few seconds and mainly seemed with a right. Required interpreter but she had no spontaneous speech. Carpal pedal spasm. Summary for DOS 3/7-3/9/07. DC DX:Diseases disorders of nervous system. Convulsions, Tetany, bronchitis, nystagmus, altered mental status, hyperventilation, headache, lumbago, fever. 8/25/08-progress notes received-3/8/07 all symptoms have resolved discharged without any medications. Continues to experience being a little dizzy when walking.


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